Unique Vaginal Cells Facilitate HIV Infection and Persistence

MedicalResearch.com Interview with:

Manish Sagar, MD Assistant Professor of Medicine, Boston University School of Medicine Boston MA 

Dr. Sagar

Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA 

MedicalResearch.com: What is the background for this study?

Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure.  The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.

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Obese Women Remain at Risk For Heart Disease, Even When Metabolically Healthy

MedicalResearch.com Interview with:
Nathalie Eckel, MSc

German Diabetes Center
Düsseldorf, Germany 

MedicalResearch.com: What is the background for this study?

 Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called “metabolically healthy obesity” and “metabolically unhealthy normal-weight”. So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

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CPAP Improved Sexual Quality of Life for Women

MedicalResearch.com Interview with:

“The new CPAP machine” by Bryan Alexander is licensed under CC BY 2.0

One CPAP model
Image by Bryan Alexander

Sebastian M. Jara, MD
Resident Physician & Research Fellow
Department of Otolaryngology – Head & Neck Surgery
University of Washington Affiliated Hospitals 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Sleep apnea is a common disorder associated with numerous health consequences and reduced quality of life. There is growing evidence that sleep apnea also affects sexual quality of life and that treatment for sleep apnea, with CPAP (continuous positive airway pressure), may improve sexual quality of life. The goal of this study was to evaluate the impact of long-term CPAP therapy on sexual quality of life in a group of men and women with sleep apnea.

Our study included 182 men and women with newly diagnosed obstructive sleep apnea, each of whom were prescribed a CPAP. Subjects completed a quality of life survey, which included questions on sexual quality of life, at their initial clinic visits and again one year later. Changes in sexual quality of scores over time were then compared between CPAP users and non-users.

Among the subjects, 72 used a CPAP nightly and 110 did not. When looking at all subjects, an overall improvement in sexual quality of life was observed in subjects that used their CPAP compared to subjects that did not, after accounting for several factors that can also affect sexual quality of life. When subgroup analysis was performed, a large improvement in sexual quality of life was noticed for women in the study. In contrast, men in the study experienced little-to-no improvement in sexual quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: These findings add to a large body of evidence that CPAP improves overall health and quality of life, in both men and women with sleep apnea. Because sleep apnea is more common men, there are fewer studies, especially those assessing sexual dysfunction, in women. However, there’s growing recognition that women, too, are affected and can benefit from CPAP use. Our findings demonstrate that improved sexual quality of life is one of the many health benefits that comes with CPAP treatment for women.While this study showed no improvements in sexual quality of life for men, CPAP has been shown to have numerous other health benefits in men and use should still be encouraged. Our hope is that the findings of this study will help motivate patients of both sexes who sleep poorly to seek evaluation for sleep apnea as treatment can have a wide-range of health benefits, including improved sexual quality of life. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, it will be important to study more comprehensive measures of sexual quality of life in sleep apnea patients. This will include both a more extensive assessment of sexual quality of life in patients themselves and effects on their bed partners. Additionally, it will be important to test the effects of other sleep apnea treatments, such as surgery. Although CPAP is the first-line treatment for sleep apnea, it can be cumbersome to wear and might adversely affect intimacy and sexual quality of life compared to other treatments. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study was funded by the National Institutes of Health. The authors of this study otherwise have no other funding, financial relationships, or conflicts of interest to disclose. 

Citation:

Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485

 

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Women With PCOS Should Be Screened for Mental Health Issues

MedicalResearch.com Interview with:
Aled Rees, MD, PhD
Neuroscience and Mental Health Research Institute
Cardiff University School of Medicine, Health Park
Cardiff United Kingdom

MedicalResearch.com: What is the background for this study?  

Response: PCOS is a common condition, affecting 5-10% of women globally, in which elevated male hormone levels can cause a range of distressing and life-limiting symptoms, including reduced fertility, irregular periods, excessive facial and body hair, and acne. Previous studies have suggested a link between PCOS and poor mental health in women but the studies were small and did not adequately take other factors that can affect mental health into consideration. In addition, high levels of testosterone during pregnancy have been reported to increase the risk of neurodevelopmental disorders, such as ADHD and autism, in children.

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Perimenopause: Oral Micronized Progesterone May Reduce Hot Flashes, Night Sweats and Sleep Problems

MedicalResearch.com Interview with:

Jerilynn C. Prior, MD Professor in the Department of Medicine Division of Endocrinology and Metabolism University of British Columbia in Vancouver

Dr. Prior

Jerilynn C. Prior, MD
Professor in the Department of Medicine
Division of Endocrinology and Metabolism
University of British Columbia in Vancouver

Dr. Prior has written the second edition of the award-winning book, Estrogen’s Storm Season—Stories of Perimenopause this year as an ebook on Google Play.


MedicalResearch.com: What is the background for this study?

Response: There is an urgent need for an effective therapy for perimenopausal hot flushes/flashes and night sweats (vasomotor symptoms, VMS). Although often considered “estrogen deficiency symptoms” VMS are common and very problematic for women in the menopause transition and who have not yet been one year without flow. About 23% of North American women are now in the perimenopausal age range. Surprisingly VMS are more common in perimenopause than in menopause; 9% of perimenopausal women have severe VMS as classified by the FDA, meaning more than 50 VMS per week of moderate to intense severity.

The commonly used therapies for VMS in midlife women have not been proven more effective than placebo! That includes combined hormonal contraceptives (CHC) and menopausal-type hormone therapy (MHT) as well as the SSRI/SNRI anti-depressants and gabapentin.  Continue reading

Women Who Walk Briskly At Least Twice Per Week Have Lower Risk of Heart Failure

MedicalResearch.com Interview with:
Dr. Somwail Rasla, MD

Primary Care Center
Brown University, Pawtucket, RI

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Heart failure (HF) is a major global epidemic. The risk of heart failure rises with age, It triples for women above age 60.
Studies have found an inverse relationship between the risk of heart failure hospitalization and midlife fitness.Walking is the most common form of physical activity reported in women
and older adults. T
his study aims at exploring the association of walking pace (speed), walking frequency and duration with the risk of incident acute hospitalized HF (HHF).

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Menopausal Hormone Therapy Linked To Favorable Cardiac Profile

MedicalResearch.com Interview with:

Mihir Sanghvi Academic Junior Doctor Barts Health NHS Trust

Dr. Sanghvi

Mihir Sanghvi
Academic Junior Doctor
Barts Health NHS Trust

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The effect of menopausal hormone therapy (MHT), previously known as hormone replacement therapy, on cardiovascular health in post-menopausal women remains controversial and unclear. Extensive observational data had suggested MHT to be cardioprotective, leading to MHT being routinely prescribed for both primary and secondary prevention of coronary heart disease (CHD). However, subsequent data from the Women’s Health Initiative (WHI) and Heart and Estrogen/Progestin Replacement Study (HERS) studies cast doubt on the beneficial cardiovascular effects of MHT; this was reflected in learned societies’ clinical guidance concerning MHT’s role in CHD prevention. The most recent randomised trial data on the subject arose from the Danish Osteoporosis Prevention Study, which indicated that women taking menopausal hormone therapy had a reduced risk of the composite endpoint of mortality, heart failure and myocardial infarction but the study has been subject to criticism [10]. In more recent work, again from the WHI, there was no difference in cardiovascular mortality in MHT users compared to placebo, although the authors themselves state that cause-specific mortality data should be interpreted “cautiously”.

The UK Biobank is an ongoing, large-scale, population-based study designed to examine determinants of health in middle and old age. Besides extensive collection of health questionnaire data, biological samples and physical measurements, it has incorporated cardiovascular magnetic resonance (CMR) imaging – the gold standard for analysis of cardiac structure and function – to provide detailed imaging phenotypes. At present, there is a paucity of data on the effects of  menopausal hormone therapy on left ventricular (LV) and left atrial (LA) volumes and function, alterations in which are markers of subclinical cardiovascular disease and have prognostic implications.

We found that in a large, population-based cohort of post-menopausal women free of cardiovascular disease, use of menopausal hormone therapy is not associated with adverse, subclinical changes in cardiac structure and function.

Indeed, we demonstrate significantly smaller LV and LA chamber volumes which have been linked to favorable cardiovascular outcomes in other settings.

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Teenage Daughters More Likely To Have Abortion If Their Mother Had One

MedicalResearch.com Interview with:
“Don't forget the teens” by Jon Seidman is licensed under CC BY 2.0Ning Liu PhD Student

Senior Research Analyst at ICES
Institute of Health Policy, Management and Evaluation
Institute for Clinical Evaluative Sciences
University of Toronto

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies suggested intergenerational tendencies between a mother and her daughter in fertility patterns, such as when they give birth to a child for the first time, or the total number of children they have during their lifetime.

We explored whether there is also an intergenerational tendency for induced abortion practices between a mother and her teen daughter.

To do so, we used anonymized records of 431,623 daughters and their mothers, and found that a teenage daughter was twice as likely to have an induced abortion if her mother had had an induced abortion.  Continue reading

Even With Preserved Ovaries Hysterectomy Linked To Increased Cardiac and Metabolic Risks

MedicalResearch.com Interview with:

Dr. Shannon Laughlin-Tommaso MD Associate Professor of Obstetrics and Gynecology Consultant, Division of Gynecology, Department of Obstetrics & Gynecology Mayo Clinic, Rochester New York

Dr. Laughlin-Tommaso

Dr. Shannon Laughlin-Tommaso MD
Associate Professor of Obstetrics and Gynecology
Consultant, Division of Gynecology, Department of Obstetrics & Gynecology
Mayo Clinic, Rochester New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy.

We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure.

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Maternal Ingestion of Placenta Has No Proven Therapeutic Benefit

MedicalResearch.com Interview with:

Placenta – Wikipedia Image

Daniel C Benyshek, PhD
Professor, Department of Anthropology
Adjunct Professor, UNLV School of Medicine
Co-Director, Metabolism, Anthropometry and Nutrition Lab
UNLV
Sharon M. Young, PhD (first author)

MedicalResearch.com: What is the background for this study?

Response: Over the last several decades, human maternal placentophagy (postpartum ingestion of the placenta by the mother) has emerged as a rare but increasingly popular practice among women in industrialized countries seeking its many purported health benefits. Human placentophagy advocates, including many midwives, placenta encapsulation specialists, lactation consultants, and mothers who have experienced positive results previously from the practice, regularly claim improved lactation, energy levels, and postpartum mood, among other benefits, as a result of placentophagy. These advocates regularly speculate that these self-reported effects are likely due to (beneficial) changes to postpartum maternal hormone profiles as a result of the practice. While maternal placentophagy is ubiquitous among land mammals, including our closest primate relatives, recent research has shown that human maternal placentophagy is unknown as a traditional cultural practice. The conspicuous cross-cultural absence of maternal placentophagy among humans (as a long-standing traditional practice) thus remains a mystery. Our study is an important first step in the scientific (evolutionary and clinical) investigation of this rare but increasingly popular maternal practice.

Our study was a double-blind, and placebo controlled trial, meaning that there was a placenta group and a placebo group, and the participants and researchers didn’t know which supplement a participant had until the end of the study. We included 27 healthy women, recruited during pregnancy, who met with the researchers 4 times across pregnancy and early postpartum. At each meeting, they answered questionnaires on topics of interest (e.g., mood, energy, bonding, social support etc.), and we collected blood and saliva samples. At the first two meetings, they were not yet taking a placenta or placebo supplement, so we could collect baseline measures for their hormones and questionnaire data. After the second meeting, they were instructed to take either placenta or placebo supplements. Once the study had ended, we compared data between the two groups to identify any differences.

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