Follicle-Stimulating Hormone Exacerbates Cardiovascular Disease in the Presence of Low or Castrate Testosterone Levels

Low testosterone (T), common in aging men, associates with cardiovascular disease. We investigated whether follicle-stimulating hormone (FSH), which is affected by T, modulates the cardiovascular effects associated with low T or castration. FSHβ-/-:low-density lipoprotein receptor (LDLR)-/- mice, untreated or castrated (orchiectomy, gonadotropin-releasing hormone agonist or antagonist), demonstrated significantly less atherogenesis compared with similarly treated LDLR-/- mice, but not following FSH delivery. Smaller plaque burden in LDLR-/- mice receiving gonadotropin-releasing hormone antagonists vs agonists were nullified in FSHβ-/-:LDLR-/- mice. Atherosclerotic and necrotic plaque size and macrophage infiltration correlated with serum FSH/T. In patients with prostate cancer, FSH/T following androgen-deprivation therapy initiation predicted cardiovascular events. FSH facilitates cardiovascular disease when T is low or eliminated.

A therapeutic target for CKD: activin A facilitates TGFβ1 profibrotic signaling

BACKGROUND

TGFβ1 is a major profibrotic mediator in chronic kidney disease (CKD). Its direct inhibition, however, is limited by adverse effects. Inhibition of activins, also members of the TGFβ superfamily, blocks TGFβ1 profibrotic effects, but the mechanism underlying this and the specific activin(s) involved are unknown.

METHODS

Cells were treated with TGFβ1 or activins A/B. Activins were inhibited generally with follistatin, or specifically with neutralizing antibodies or type I receptor downregulation. Cytokine levels, signaling and profibrotic responses were assessed with ELISA, immunofluorescence, immunoblotting and promoter luciferase reporters. Wild-type or TGFβ1-overexpressing mice with unilateral ureteral obstruction (UUO) were treated with an activin A neutralizing antibody.

RESULTS

In primary mesangial cells, TGFβ1 induces secretion primarily of activin A, which enables longer-term profibrotic effects by enhancing Smad3 phosphorylation and transcriptional activity. This results from lack of cell refractoriness to activin A, unlike that for TGFβ1, and promotion of TGFβ type II receptor expression. Activin A also supports transcription through regulating non-canonical MRTF-A activation. TGFβ1 additionally induces secretion of activin A, but not B, from tubular cells, and activin A neutralization prevents the TGFβ1 profibrotic response in renal fibroblasts. Fibrosis induced by UUO is inhibited by activin A neutralization in wild-type mice. Worsened fibrosis in TGFβ1-overexpressing mice is associated with increased renal activin A expression and is inhibited to wild-type levels with activin A neutralization.

CONCLUSIONS

Activin A facilitates TGFβ1 profibrotic effects through regulation of both canonical (Smad3) and non-canonical (MRTF-A) signaling, suggesting it may be a novel therapeutic target for preventing fibrosis in CKD.

Knowledge of and attitudes towards sexual and reproductive health in adults in Shiraz: a need for further education

Sexual health influences general well-being and the overall quality of life of all men and women. This study in Shiraz, Islamic Republic of Iran, aimed to assess the level of knowledge of and attitudes towards sexual and reproductive health among adults. In a cross-sectional study in 2010, 276 men and 281 women were recruited at pre-marital counselling courses and completed a 33-item anonymous questionnaire in private. The overall level of knowledge of men and women was low. Both men and women had low scores on knowledge of genital anatomy, sexually transmitted infections and contraceptive use. The majority of participants had positive attitudes towards implementing educational programmes on sexual and reproductive health issues for young adults and prior to marriage. Efficient educational programmes providing up-to-date information about sexual and reproductive health are needed in the Islamic Republic of Iran.

Comparison of pap smear quality with anatomical spatula method and the common method (spatula-cytobrush): a single blind clinical trial

BACKGROUND

Cervical cancer is the third most common cancer in women in the world. Papanicolaou smear is known as a standard test for cervical cancer screening; however, the most important challenge is high rates of false negative results. The aim of this study was to compare the quality of smears obtained by anatomical spatula and spatula-cytobrush. The most important factor in false negative result is inappropriate tool of sampling.

METHODS

One hundred married women participated in this single blind clinical trial. All participants were interviewed; two samples were obtained from every participant: one with spatula-cytobrush and another one with anatomical spatula. All slides were encoded and were assessed by two pathologists. Then, data were analyzed by means of kappa coefficient.

RESULTS

Cell adequacy was 96.1 % in anatomical spatula method and 91.2 % in spatula-cytobrush method (p= 0.016). The rates for endocervical cells and metaplasia cells in anatomical spatula method were 70.6% and 24.5% respectively and these amounts were 69.6% and 24.5% respectively in the spatula-cytobrush method (p <0.001). No one reported any pain and the amount of bleeding was 38.2% in both methods (P>0.05). Regarding infection and inflammatory reactions there was no statistically significant difference between two methods (p>0.05).

CONCLUSION

Based on our findings in this study, results of sampling with anatomical spatula method were more acceptable and better than those with spatula-cytobrush sampling.

A comparison of sexual outcomes in primiparous women experiencing vaginal and caesarean births

BACKGROUND AND OBJECTIVE

We conducted this study to evaluate and compare postpartum sexual functioning after vaginal and caesarean births.

MATERIALS AND METHODS

This was a cross-sectional study that was carried out in postnatal health care in a hospital. A total of 50 primiprous women who had given birth 6-12 months ago and came to the hospital for postnatal care were asked to join the study. Forty of the women completed the entire questionnaire. Among these women, 20 delivered spontaneously with mediolateral episiotomy and 20 had elective caesarean section. Sexual function was evaluated by a validated, self-created questionnaire. A statistical evaluation was carried out by SPSS v.11. A two-part self-created validated questionnaire for data collection was administered regarding sexual function prior to pregnancy and 6-12 months postpartum.

RESULTS

The median time to restart intercourse in the normal vaginal delivery with episiotomy (NVD/epi) group was 40 days and in the caesarean section (C/S) group was 10 days postpartum. The most common problems in the NVD/epi group was decreased libido (80%), sexual dissatisfaction (65%), and vaginal looseness (55%). In the C/S group, the most common problems were vaginal dryness (85%), sexual dissatisfaction (60%), and decreased libido (35%). There were clinically significant differences between the two groups regarding sexual outcomes, but these differences were not statically significant.

CONCLUSION

Postnatal sexual problems were very common after both NVD/epi and C/S. Because sexual problems are so prevalent during the postpartum period, clinicians should draw more attention to the women's sexual life and try to improve their quality of life after delivery.

A comparison between the efficacy of dydrogesterone and calcium plus vitamin D in improving women's general health

OBJECTIVE

The aim of this randomized, double-blind, placebo-controlled clinical trial was to evaluate the effect of dydrogesterone and calcium plus vitamin D on young women's general health.

METHOD

One hundred and eighty students studying at Shiraz University were recruited. Students completed the General Health Questionnaires (GHQ-28) prior to participation. They were then randomly assigned to take a tablet containing either 5 mg of dydrogesterone, 500 mg of calcium plus 200 mg of vitamin D, or a placebo twice daily from the 15th to the 24th day of their menstrual cycle for 2 consecutive cycles, and to complete the same questionnaires during both the intervention cycles.

RESULTS

The effects of dydrogesterone and calcium plus vitamin D on general health scores were similar during the first month of intervention (11.41 ± 4.28, 12.23 ± 3.76, respectively) (p>0.05) and both of them were more effective than placebo (16.69 ± 3.28) (p<0.05). However, dydrogesterone was more effective than calcium plus vitamin D and placebo during the second month of intervention (4.33 ± 2.69, 6.2 ± 3.55, 14.39 ± 3.45, respectively) (p<0.05). No significant differences between groups regarding drugs' side effects (p>0.05) were found.

CONCLUSION

Both dydrogesterone and calcium D were more effective than placebo in promoting women's general health. Dydrogesterone was, however, more efficient than calcium plus vitamin D.