BioResearch Open Access最新文献

Most vulvodynia patients receive combinations of several treatment modalities for their chronic painful condition. If conservative treatments fail, vestibulectomy is considered to be the ultimate treatment option for localized provoked vulvodynia (LPV). The aim of this descriptive study was to analyze relief of pain, quality of life (QoL), and complications associated with combining surgery with conservative treatments among LPV patients, both in short term and after 3 years of follow-up. The study population consisted of a retrospective patient cohort of surgically (n = 16) and only conservatively (n = 50) treated LPV patients. QoL data were assessed by a validated questionnaire (RAND-36). Data were collected by reviewing patient records and by aid of postal questionnaires. Efficacy of treatments in relief of pain was measured by numerical rating scale (NRS). Two months after surgery, the NRS scores assessed by a physician were lower in the surgery group than in patients treated only conservatively (p = 0.008). However, after a median of 36 months of follow-up, self-reported NRS scores and QoL showed no difference between the two patient cohorts. Complication rate after vestibulectomy was 18.8%. The findings suggest that combining surgery with conservative treatments may result in a more effective short-term reduction of pain. However, the effect seemed to be only temporary, as no long-term benefit was achieved.

This study compared the effects of a high-calcium vitamin D fortified milk with added FOS-Inulin versus regular milk on serum parathyroid hormone (PTH), vitamin D status, grip strength (GS), as well as bone density in Chinese premenopausal women over 52 weeks. Premenopausal women (n = 133), mean age 41 (±5.1) years were randomized into control (n = 66; regular milk at 500 mg calcium per day) or intervention (Int; n = 67; fortified milk at 1200 mg calcium, 15 μg vitamin D, and 4 g FOS-Inulin per day) groups. Assessments were at baseline, weeks 12, 24, 36, and 52 for changes in vitamin D status, levels of PTH, and GS. Bone mineral densities (BMDs) of the lumbar spine (LS), femoral neck (FN), and whole body (WB) were assessed at baseline and week 52 using GE Lunar iDEXA (GE Healthcare, Madison, WI). At baseline, WB lean mass was positively associated with LS BMD (r = 0.30, p < 0.001) and FN BMD (r = 0.33, p = 0.003). Baseline 25(OH) vitamin D3 levels were 48.6 and 53.2 nmol/L (p = 0.57), respectively, and after the 12 months at 60.8 nmol/L (Int) versus 55.0 nmol/L (controls; p < 0.05 for change from baseline for both groups; no difference between groups at week 52). PTH levels decreased in both groups compared to baseline (p < 0.001), with no significant difference between groups. WB bone mineral content (BMC) and FN Z-score increased significantly in the Int group (p = 0.024 and p = 0.008). GS was positively associated with body weight, increasing in both groups over 52 weeks. Fortified milk improved vitamin D status, WB BMC, and Z-score of the FN, while regular milk maintained BMD. In addition, vitamin D status and GS improved.

Vascularization remains a substantial limitation to the viability of engineered tissue. By comparing in vivo vascularization dynamics of a self-assembled prevascular endothelial-fibroblast model to avascular grafts, we explore the vascularization rate limitations in implants at early time intervals, during which tissue hypoxia begins to affect cell viability. Scaffold-free prevascular endothelial-fibroblast constructs (SPECs) may serve as a modular and reshapable vascular bed in replacement tissues. SPECs, fibroblast-only spheroids (FOS), and silicone implants were implanted in 54 Sprague Dawley rats and harvested at 6, 12, and 24 h (n = 5 per time point and implant type). We hypothesized that the primary endothelial networks of the SPECs allow earlier anastomosis and increased vessel formation in the interior of the implant compared to FOS and silicone implants within a 24 h window. All constructs were encapsulated by an endothelial lining at 6 h postimplantation and SPEC internal cords inosculated with the host vascular network by this time point. SPECs had a significantly higher microvascular area fraction and branch/junction density of penetrating cords at 6-12 h compared with other constructs. In addition, SPECs demonstrated perivascular cell recruitment, lumen formation, and network remodeling consistent with vessel maturation at 12-24 h; however, these implants were poorly perfused within our observation window, suggesting poor lumen patency. FOS vascular characteristics (microvessel area and penetrating cord density) increased within the 12-24 h period to represent those of the SPEC implants, suggesting a 12 h latency in host response to avascular grafts compared to prevascular grafts. Knowledge of this temporal advantage in in vitro prevascular network self-assembly as well as an understanding of the current limitations of SPEC engraftment builds on our theoretical temporal model of tissue graft vascularization and suggests a crucial time window, during which technological improvements and vascular therapy can improve engineered tissue survival.

Although traditional high-intensity interval training (HIIT) has been effective in improving body composition and physical fitness, it is unclear how multimodal HIIT affects these variables. This study compared the differences between these two training programs on body composition and physical fitness in apparently healthy, nonobese young adult females. A total of 16 participants (mean age = 23 ± 5.08 years) completed a 12-week HIIT intervention with two treatment groups: rowing and multimodal. Immediately before and after the intervention, the following measures were assessed: body mass index (BMI), total body mass, waist circumference, waist-to-height ratio, total body fat %, visceral adipose tissue, lean mass, bone mineral outcomes, cardiovascular fitness, and muscular fitness. A general linear model with repeated measures was used to assess changes over time for the group as a whole, as well as between-group differences. For the group as a whole, there were significant decrease in total body fat % (p = 0.04) and significant increases in BMI (p = 0.015), total body mass (p = 0.003), lean mass (p < 0.001), bone mineral content (BMC) (p < 0.001), VO₂max (p = 0.01), broad jump (p = 0.001), squat endurance (p = 0.006), press (p < 0.001), back squat (p < 0.001), and deadlift (p < 0.001) one repetition maximum (1RM). The multimodal group (p < 0.001) increased deadlift 1RM significantly more than the rowing group (p = 0.002). HIIT can be an effective means for improving cardiovascular and muscular fitness, increasing lean mass and BMC, and thereby improving cardiometabolic as well as musculoskeletal health in nonobese females. Using a multimodal approach may give the added benefit of superior muscular strength increases.

To evaluate the feasibility (adherence to the study protocol and satisfaction) of using an activity tracking device (ATD) in group prenatal care. Women participated if they (1) were in group prenatal care, (2) owned a smartphone, and (3) had no activity restrictions. Women were instructed to wear and sync the ATD daily. Protocol adherence and satisfaction were assessed via surveys. Mixed models assessed the relationship between gestational age and ATD data. Self-reported energy expenditure from the Pregnancy Physical Activity Questionnaire (PPAQ) was compared with ATD-calculated energy expenditure. The baseline characteristics of the 49 women were as follows: 24 years old, prepregnancy body mass index 28, 80% Hispanic, 86% nulliparas, and 21 weeks of gestation. Of the 30 women who completed the follow-up survey, 47% self-reported wearing the ATD daily, 27% reported a lost or broken ATD, and 22% reported technical problems; however, 97% enjoyed wearing it, 100% would recommend it to a pregnant friend, and 77% thought it helped them reach activity goals. According to ATD data, the median active days were 47 (interquartile range [IQR] 21-79) and the median proportion of active days of potential days was 43.7% (IQR 15.4-77.1). For women who wore the ATD for the first 7 days, mean steps/day were 7574 (range 3076-15,828), active minutes/day were 277 (range 145-475), and sedentary hours/day were 12 (range 7.8-16.2). As gestational age increased, mean log steps decreased, mean active minutes decreased, and mean sedentary hours increased in unadjusted and adjusted models (p < 0.001 all comparisons). There were no differences in mean energy expenditure (MET-h/week) by PPAQ or ATD data at 28 weeks of gestation [231 (62-927 range) vs. 238 (212-290 range), p = 0.74] and at 36 weeks of gestation [145 (35-581 range) vs. 222 (196-272 range), p = 0.27]. Most women reported high satisfaction with an ATD in group prenatal care, yet adherence to the study protocol was low and ATD technical problems were common. As gestational age increased, activity decreased while sedentary time increased, suggesting that additional research is needed to find ways to engage women in physical activity during pregnancy.

Adenomatoid uterine tumors are rare, and their appearance on medical imaging modalities is not well established. We present a case of an adenomatoid uterine tumor reviewing a unique sonographic presentation, magnetic resonance imaging (MRI), gross surgical appearance of the tumor, and microscopic pathology images. A 29-year-old gravida 0 Caucasian woman presented with dysmenorrhea, menorrhagia, and desire to conceive. Transvaginal ultrasound revealed a 2.7 cm round, well-circumscribed posterior intramural uterine mass. The mass was hyperechoic centrally with a thin hypoechoic rim. Color Doppler imaging revealed a prominent vascular rim around the periphery of the mass as well as central vascularity not typical for a leiomyoma. MRI, with and without intravenous gadolinium, was obtained showing a 2.7 cm posterior fundal mildly enhancing uterine mass suggestive of leiomyoma. The mass had a heterogeneous signal pattern on T2-weighted images, and no fat component was noted within the mass. Repeat transvaginal ultrasound showed interval growth of the mass to 3.5 cm with a lipomatous appearance. Adenomatoid uterine tumors are rare and may be mistaken for uterine leiomyomata. Unique features include sonographic appearance of central hyperechogenicity with a hypoechoic rim and prominent peripheral and central vascularity in conjunction with MRI revealing a heterogeneous signal pattern on T2-weighted images without fat component. Gross surgical appearance reveals a nondiscrete capsule and secretion of mucoid material when the mass is exposed. We present a case of adenomatoid tumor providing sonographic, MRI, surgical, and pathological correlation. The patient subsequently conceived spontaneously and delivered at term by cesarean section. The patient underwent a preoperative evaluation with complete blood count, comprehensive metabolic panel, blood type with antibody screen, and pregnancy test. She underwent laparoscopic excision with robotic assistance for removal of the tumor. Grossly, the uterine mass had a very soft consistency atypical for a uterine leiomyoma making dissection more challenging. During dissection the mass diffusely secreted a mucoid material although the capsule was not disrupted. The lesion was excised intact and was removed from the peritoneal cavity in an endocatch bag without internal morcellation. Microscopic examination revealed an adenomatoid tumor.

Owing to conflicting results of the association between body composition and bone mineral density (BMD), we investigated the relationship between fat mass (FM), lean mass (LM), and BMD in New Zealand postmenopausal women. We hypothesized that increased LM will indicate a higher BMD. A cross-sectional study was performed examining the associations between body composition, anthropometric measures, activity energy expenditure, and bone health status (using dual-energy X-ray absorptiometry [DXA]). A total of 127 healthy postmenopausal women aged between 54 and 81 years. Both FM and LM were significantly associated with BMD at all sites. However, LM, not FM, was the strongest predictor of femoral neck (FN) BMD (β = 0.497, p < 0.001), hip BMD (β = 0.495, p < 0.001), spine BMD (β = 0.449, p < 0.001), and whole body BMD (β = 0.406, p < 0.001). Age was negatively associated with FN and hip BMD. LM was positively associated with FN, spine, hip, and whole body BMD. Our findings suggest the need to increase LM rather than FM highlighting the importance of physical activity for this age group.

Osteoradionecrosis (ORN) is a common consequence resulting from radiation in patients with cancer. Presently, hyperbaric oxygen therapy (HBOT) is proposed to have a role in improving wound healing in ORN patients. There is no strong scientific evidence to confirm the benefits of HBOT for treatment of ORN as an adjunctive treatment. This study aimed to determine the benefits of adjunctive treatment of HBOT in ORN. A retrospective study was conducted at the Srinagarind Hospital, the Faculty of Medicine, Khon Kaen University, Thailand, between 2011 and 2017. The patients diagnosed with ORN, who received adjunctive HBOT before the operation, were enrolled. Complete healing of wounds was the primary outcome. There were 84 ORN patients with a mean age of 58.78 years; 54.76% were male and 45.24% were female. HBOT had a role significant in improving wound healing of ORN patients with stages 1 and 2. Poisson regression analysis showed that stage 3 of ORN negatively correlated with the number of HBOT dives (p = 0.001, incidence rates ratio = 0.85). In conclusion, HBOT improved wound healing of ORN patients with stages 1 and 2. In addition, stage 2 of ORN patients significantly required the highest number of HBOT dives compared to other types of ORN to promote wound healing, whereas stage 3 patients, who underwent bone debridement combined with HBOT, initiated to success of treatment process and required a smaller number of dives.

Over 200,000 women are diagnosed with breast cancer each year, and incarcerated women face unique risks associated with poor access to healthcare. Regular mammography can diagnose breast cancer early, giving the patient the best chance of survival. The objective of this study was to determine the proportion of jail incarcerated women who have received a mammogram and were up-to-date based on the most recent United States Preventive Services Task Force recommendations. This was a secondary analysis of data collected among jailed women who participated in a cervical cancer literacy program. Rates of mammography were calculated for the group overall and for those women 50 years or older. Subgroups were compared using chi-squared tests. Two hundred sixty-one women were included in the analysis, of which 42.1% (N = 110) had ever had a mammogram. Of women 50 years old or older (N = 28), 75.0% had ever received a mammogram, yet only 39.3% were up-to-date (within the past 2 years). Factors associated with up-to-date mammography included being up-to-date on cervical cancer screening (76.9%) compared with women who were not up-to-date on cervical cancer screening (12.5%), p < 0.01, and women experiencing intimate partner violence (IPV) in the past year (71.4%) compared with women with no IPV in the past year (14.2%), p = 0.02. The low rates of up-to-date mammography highlight the need for more breast cancer prevention programming among women with criminal justice histories.

The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms. Comorbid conditions and functional status were measured with the Charlson Comorbidity Index and Duke Activity Status Index. Logistic regression models were used to evaluate symptom differences in older and younger women adjusting for ACS diagnosis, functional status, body mass index (BMI), and comorbid conditions. Analyses were stratified by age, and interaction of symptom by age was tested. Four hundred women were enrolled. Mean age was 61.3 years (range 21-98). Older women (n = 163) were more likely to have hypertension, hypercholesterolemia, never smoked, lower BMI, more comorbid conditions, and lower functional status. Younger women (n = 237) were more likely to be members of minority groups, be college-educated, and have a non-ACS discharge diagnosis. Younger women had higher odds of experiencing chest discomfort, chest pain, chest pressure, shortness of breath, nausea, sweating, and palpitations. Lack of chest symptoms and shortness of breath (key symptoms triggering a decision to seek emergency care) may cause older women to delay seeking treatment, placing them at risk for poorer outcomes. Younger African American women may require more comprehensive risk reduction strategies and symptom management.