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PubMedDate not supplied

Serum leptin levels during childhood and adolescence: relationship with age, sex, adiposity and puberty.

We studied serum leptin levels in 189 healthy children to evaluate related factors during childhood and adolescence. Leptin correlated with body mass index (BMI), triceps skinfold thickness (p<0.001) and body weight (p<0.01). Obese children and girls had higher leptin levels than non-obese children and boys, respectively (p<0.001). In girls, leptin correlated positively with age, skinfold thickness and BMI (p<0.001). In boys, leptin correlated negatively with age (p<0.001) and positively with skinfold thickness (p<0.05). Prepubertal boys had higher leptin levels than prepubertal girls and pubertal boys (p<0.05). Pubertal girls had higher leptin levels than prepubertal girls and pubertal boys (p<0.001). Leptin levels in girls were higher at Tanner stages 4 and 5 than at stage 1 (p<0.001). In conclusion, serum leptin levels are related with adiposity, have obviously age-related gender differences during childhood and adolescence, and may be involved in the maturation of reproductive capacity.

Adolescent↗
PubMed1992

[Cell-mediated immune reactivity to sperm in disorders of human reproduction].

Besides the pathological anti-sperm humoral immunity, pathological anti-sperm cell-mediated immunity is considered as a crucial facet of the disturbances of human reproduction (male and female infertility, recurrent abortions, endometriosis, late EPH gestosis, fetal hypotrophy). A precise and objective method is designed, based on a one-step agarose Leukocyte Migration Inhibition Factor assay. The migration areas are evaluated by a computer-assisted image analysis system. Optimal concentrations of leukocytes and sperm, as well as technical conditions are described. The Radius Migration Indexes and Area Migration Indexes are computed and expressed as a Migration Index percentage for each patient or control. Preliminary clinical results indicate a highly significant association between leukocyte migration inhibition and cases of "immunopathological" infertility and repeated fetal loss.

Cell Migration Inhibition↗
PubMed1996

[Genetic-demographic analysis of the population of native inhabitants of the Samburg tundra].

Genetic-demographic parameters (Tundra Nentsi, Forest Nentsi, and Komi) of the population of native inhabitants of the Samburg Tundra (population size, age and sex structure, sex ratio) are presented. The size of the portion of the population of reproductive age (35.5% of the total), family size (3.04), and the predominance of the portion of the population under reproductive allow us to classify this population as growing. Results of analysis of marriage structure, mixing, and migration processes in the group of Tundra Nentsi are presented. It is shown, that the gene contribution of Tundra Nentsi themselves into the population is 74%. The index of endogamy is 42.4%. The inbreeding coefficient in the population is 0.003. It is demonstrated that the average number and variance of births for Tundra Nentsi women who have passed their reproductive years are 7.55 and 11.07, respectively. Crow's index of total selection (Itot) and its components (Im, I(f)) were 0.75, 0.47, and 0.19, respectively.

Adolescent↗
PubMed1984

Is wide availability of abortion essential to national population growth control programs? Experiences of 116 countries.

No nation wanting to reduce its growth rate to less than or equal to 1% can expect to do so without the widespread use of abortion. This study, based on the experience of 116 of the world's largest countries, supports the contention that abortion is essential to any national population growth control effort. Existing circumstances in developed countries have facilitated reduction of growth rates to less than 1%, with abortion rates generally in the range of 200 to 500 per 1000 live births. However, developing countries are faced with a different and more difficult set of circumstances that require even greater reliance on abortion. These obstacles include a young population with resultant rapidly growing numbers of young fertile women, poor contraceptive use-effectiveness, low prevalence of contraception, and poor or nonexistent systems for providing contraceptives. By virtue of their profession, physicians play a critical role in family planning and carry a special responsibility in ensuring that abortion services are available to all women who need them.

Abortion, Induced↗
PubMed2001

Low-to-moderate alcohol consumption and breast cancer risk by age 50 years among women in Germany.

Studies of the association between alcohol drinking and breast cancer show a tendency towards an increase in risk for high consumption levels but yield less consistent results for low-to-moderate levels, particularly among premenopausal women. In a population-based case-control study in Germany, the authors determined the effect of alcohol consumption at low-to-moderate levels on breast cancer risk among women up to age 50 years. The study included 706 case women whose breast cancer had been newly diagnosed in 1992-1995 and 1,381 residence- and age-matched controls. In multivariate conditional logistic regression analysis, the adjusted odds ratios for breast cancer were 0.71 (95% confidence interval (CI): 0.54, 0.91) for average ethanol intake of 1-5 g/day, 0.67 (95% CI: 0.50, 0.91) for intake of 6-11 g/day, 0.73 (95% CI: 0.51, 1.05) for 12-18 g/day, 1.10 (95% CI: 0.73, 1.65) for 19-30 g/day, and 1.94 (95% CI: 1.18, 3.20) for > or = 31 g/day. The association with high daily ethanol intake of > or = 19 g was modified by educational level, such that odds ratios were 3.7, 1.6, and 0.7 for women with low, moderate, and high levels of education, respectively. These data suggest that low-level consumption of alcohol does not increase breast cancer risk in premenopausal women.

Adolescent↗
PubMed1996

[The mineral requirements and mineral status in pregnancy].

Recommendations for mineral intakes during pregnancy differs around the world, effecting the inadequacy of knowledge about mineral requirements in human reproductions. The most important minerals for the pregnant women and their outcome are iron, calcium and zinc. It is very difficult the precise determination of amount of minerals needed because the appropriate techniques used can not be used for pregnant woman. Because of hormonal changes during pregnancy the blood levels of minerals are not the best index for assessment of mineral status. The prepregnancy nutrition is one of the most important determinant of nutritional status and pregnancy outcome. There are lacking of cut-off values in serum for the most minerals, deficiency to be screened. Therefore, the assessment of nutritional status during pregnancy serves seriously problem. More research is required before we can confident about advising women to use mineral supplements during pregnancy.

Female↗
PubMed2005

Absorptiometric assessment of muscle-bone relationships in humans: reference, validation, and application studies.

This report summarizes some preliminary absorptiometric (DXA, QCT/pQCT) studies from our laboratory, supporting the following assumptions. 1. In Homo sapiens at all ages, natural proportionality between DXA-assessed bone mineral mass (bone mineral content, BMC) and muscle mass (lean mass, LM) of the whole body or limbs is specific for ethnicity, gender, and reproductive status, but not for body weight, height, or body mass index. 2. This proportionality is sensitive to many kinds of endocrine-metabolic perturbations. 3. Percentilized or Z-scored charts of the BMC/LM correlations as determined in large samples of healthy individuals can provide a diagnostic reference for evaluating proportionality in different conditions. 4. Employing exclusively DXA, this methodology can be applied to discriminate between "disuse-related" and "metabolic" osteopenias based on the finding of normal or low BMC/LM percentiles or Z-scores respectively, with important therapeutic and monitoring implications.

Absorptiometry, Photon↗
PubMed1996

Assessment of uterine artery blood flow on the day of human chorionic gonadotropin administration by transvaginal color Doppler ultrasound in an in vitro fertilization program.

OBJECTIVE: To assess whether measurement of uterine artery blood flow impedance (the pulsatility index) as determined by transvaginal color Doppler ultrasound on the day of hCG administration in patients undergoing IVF can predict pregnancy and implantation rates. DESIGN: Prospective observational study of women undergoing IVF. SETTING: A tertiary referral center for assisted reproduction. PATIENTS: One hundred thirty-five patients undergoing 139 IVF cycles. INTERVENTION: Transvaginal color Doppler assessment of uterine artery pulsatility index on the day of administration of hCG. MAIN OUTCOME MEASURES: Mean pulsatility index of the left and right uterine arteries, pregnancy rate, and embryo implantation rate. RESULTS: The patients were grouped into pregnant and nonpregnant groups and according to whether the pulsatility index was low (1.00 to 1.99), medium (2.00 to 2.99), or high (> or = 3.00). The pregnancy rates were 13.8%, 34.7%, and 14.3% for the low, medium, and high pulsatility index groups, respectively, and were not significantly different. The implantation rates for the same groups were 10.7%, 16.3%, and 5.4%, respectively. The implantation rate for all the patients with pulsatility index < 3.00 (and especially 2.00 to 2.99) was significantly higher than the high pulsatility index group. CONCLUSIONS: The study suggests that the measurement of uterine artery pulsatility index on the day of hCG predicts subsequent implantation rates. It may allow the administration of hCG to be deferred until uterine artery pulsatility index falls to < 3.00, which may result in improved implantation rates.

Adult↗
PubMed2000

Comparison of two dosages of recombinant human follicle-stimulating hormone in Chinese women undergoing controlled ovarian stimulation: prospective randomised double-blind study.

OBJECTIVE: To compare two dosages of recombinant human follicle-stimulating hormone for controlled ovarian stimulation. DESIGN: Prospective, randomised double-blind study. SETTING: Tertiary assisted reproduction unit, Hong Kong. PARTICIPANTS: Forty subfertile Chinese women aged 24 to 38 years undergoing in vitro fertilisation. Entry criteria included good physical and mental health, and a body mass index between 18 and 29 kg/m2. Exclusion criteria were subfertility caused by an endocrine abnormality, polycystic ovarian syndrome, or absent ovarian function; previous assisted reproduction treatment in which fewer than three oocytes were retrieved; prior hospitalisation due to severe ovarian hyperstimulation syndrome; chronic cardiovascular, hepatic, renal, or pulmonary disease; alcohol or drug abuse; and the administration of investigational drugs within the previous 3 months. INTERVENTION: Injection of recombinant follicle-stimulating hormone, 100 IU/d or 200 IU/d. MAIN OUTCOME MEASURES: The number of oocytes, total dose of drug used, and pregnancy rates. RESULTS: Compared with the 20 women receiving 200 IU/d, the 20 who received 100 IU/d had a significantly lower median number of oocytes retrieved and median total dose of drug used (7.5 versus 15.0 [P<0.001] and 1200 IU versus 2000 IU [P<0.001], respectively). The pregnancy rates in the fresh cycles were similar (20%) in both groups, but the cumulative pregnancy rates in the 100 IU/d and 200 IU/d groups were 20.0% and 45.0% per stimulated cycle, respectively. The incidence of ovarian hyperstimulation syndrome in the 100 IU/d and 200 IU/d groups was 5.0% and 20.0%, respectively. CONCLUSIONS: Use of 100 IU/d of recombinant follicle-stimulating hormone requires a lower total dose but results in the harvest of half the number of oocytes compared with when a dosage of 200 IU/d is used.

Adult↗
PubMed1989

[Effect of progestin therapy on the level of cytoplasmic receptors in patients with cancer of the corpus uteri].

Correlations were identified between tumor morphobiochemical characteristics and basic parameters of reproductive homeostasis in 256 cases of endometrial carcinoma. A correlation was established between the levels of cytoplasmic receptors to estradiol (ER) and progesterone (PR), on the one hand, and morphological differentiation and spontaneous secretion in tumor tissue, on the other. A direct correlation was found between ER and metastatic spread to regional lymph nodes, and no correlation--between ER and PR and major parameters of reproductive homeostasis. A significant decrease in ER, PR, gonadotropins, estradiol and colpocytological reaction indexes followed hormone therapy with hydroxyprogesterone capronate and medroxyprogesterone acetate. The criteria of endometrial carcinoma patients sensitivity to progestin therapy were as follows: ER and PR levels--more than 30.0 fmol/mg protein, estradiol--more than 30-50 pg/ml and colpocytological index--over 40%.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1995

Reproductive factors and family history of breast cancer in relation to plasma estrogen and prolactin levels in postmenopausal women in the Nurses' Health Study (United States).

Parity, age at first birth, age at menarche, and a family history of breast cancer have each been associated consistently with breast cancer risk. Whether this increase in risk is mediated, at least in part, through changes in endogenous hormone levels is unclear. We conducted a cross-sectional study of the relationships between these factors and plasma hormone levels in 216 healthy postmenopausal women in the Nurses' Health Study (United States). The hormones evaluated were estradiol, percent and total free estradiol, percent and total bioavailable estradiol, estrone, estrone sulfate, and prolactin. After controlling for age, body mass index (weight/height2), and alcohol use, we observed inverse associations between estrone sulfate and parity (r = -0.15, P = 0.03) and between percent bioavailable estradiol and age at first birth (r = -0.17, P = 0.02). Although women with a family history of breast cancer tended to have higher estrogen levels compared with women without such history, the differences were not statistically significant. Age at menarche was not related significantly to any of the hormones. These data provide some additional evidence that the inverse relationship observed between parity and breast cancer risk may be mediated, at least in part, through decreased estrogen levels. Our data do not support a substantial influence of either family history of breast cancer or age at menarche on postmenopausal estrogen or prolactin levels.

Adult↗
PubMed2004

Beneficial effect of microsurgical varicocelectomy on human sperm DNA integrity.

BACKGROUND: Human sperm DNA damage may adversely affect reproductive outcomes, and the spermatozoa of infertile men possess substantially more DNA damage than that of fertile men. To date, there is no available treatment for men with high levels of sperm DNA damage. The objective of this study was to examine the effect of varicocelectomy on sperm DNA denaturation (DD, an index of sperm DNA damage) in infertile men with a clinical varicocele. METHODS: We reviewed the reports of 37 men who underwent microsurgical varicocelectomy at our institution from September 2001 to July 2002. Standard semen parameters and the percentage of spermatozoa with DD (monitored by flow cytometry analysis of acridine orange-treated spermatozoa) were assessed before and 6 months after varicocelectomy. RESULTS: The percentage of spermatozoa with DD decreased following varicocelectomy compared with pre-operatively (27.7 versus 24.6%, respectively, P < 0.05). Sperm concentration and the percentages of motile sperm and normal forms (WHO criteria) increased following varicocelectomy, but the difference did not reach statistical significance. CONCLUSIONS: Our data suggest that varicocelectomy can improve human sperm DNA integrity in infertile men with varicocele. These data represent the first report of improved sperm DNA integrity after therapy and further support the beneficial effect of varicocelectomy on human spermatogenesis.

Adult↗
PubMed2005

Redefining the relationship between sperm deoxyribonucleic acid fragmentation as measured by the sperm chromatin structure assay and outcomes of assisted reproductive techniques.

OBJECTIVE: To test the hypothesis that couples with sperm chromatin structure assay (SCSA) DNA fragmentation index (DFI) values >27% would not achieve pregnancy with assisted reproductive techniques (ART) and to investigate how DFI and high DNA stainability (HDS), as measured by the SCSA, affect fertilization, cleavage, implantation, and pregnancy rates in IVF cycles. DESIGN: Prospective clinical study. SETTING: Academic human reproduction laboratory. PATIENT(S): One hundred couples undergoing IVF with conventional insemination or intracytoplasmic sperm injection. INTERVENTION(S): Testing with SCSA was performed by SCSA Diagnostics (Brookings, South Dakota) on a semen aliquot taken from ejaculate used for ART. MAIN OUTCOME MEASURE(S): Relating total DFI and HDS to conventional semen parameters and cycle-specific outcomes after ART. RESULT(S): Nine of nineteen couples achieved clinical pregnancy when DFI was > or =27%, and 2 of 22 couples achieved clinical pregnancy when DFI was < or =9%. One of nine couples achieved clinical pregnancy with HDS >17%. The DFI was negatively correlated with sperm density (r = -0.23, P<.03) and motility (r = -0.55, P<.00), and HDS was negatively correlated with sperm density (r = -0.37, P<.00). CONCLUSION(S): Sperm chromatin structure assay failed to identify elevated DFI thresholds for negative pregnancy outcome after ART. Patients with low DFI (< or =9%) were least likely to become pregnant, which is also contradictory to SCSA marketing, which states that DFIs of < or =15% have excellent fertility potential. Patients with HDS > or =17% had low pregnancy rates, indicating decreased fertility potential, which deserves further investigation. Larger studies are necessary to confirm that low DFI is associated with decreased fertility and, if proved, might redefine the use of the SCSA in evaluating infertility.

Adult↗
PubMed1997

Testosterone substitution normalizes elevated serum leptin levels in hypogonadal men.

The ob gene product leptin (OB) is a feedback signal from the adipocyte to the hypothalamus and is involved in regulation of food intake and energy expenditure in rodents. A major determinant of serum OB levels is fat mass. Several studies suggest that men have lower OB levels than women even after adjustment for percent body fat. We, therefore, investigated the influence of testosterone (T) substitution in hypogonadal men on serum OB levels. Hypogonadal men with T levels of 3.6 nmol/L or less and off substitution therapy for at least 3 months were assigned to two treatment groups: testosterone enanthate (TE; 250 mg, i.m., every 21 days; n = 10) or a single s.c. implantation of 1200 mg crystalline T (TPEL; n = 12). Blood samples for determination of T, 5 alpha-dihydrotestosterone (DHT), sex hormone-binding globulin, and 17 beta-estradiol were obtained before therapy and then every 21 days until day 189 and at follow-up visits on days 246 and 300. Serum OB levels were assessed on days 0, 42, 84, 126, 168, and 300. OB levels were referred to a normal range for men based on the analysis of OB levels in 393 adult men. Substitution with T led to a large rise in T and DHT in both groups compared to baseline values (average T, days 21-189: TE, 14.33 +/- 2.63 nmol/L; TPEL, 24.98 +/- 1.64; average DHT, days 21-189: TE, 4.20 +/- 0.57 nmol/L; TPEL, 5.11 +/- 0.56; P < or = 0.05). Concomitantly, 17 beta-estradiol increased in both groups, and sex hormone-binding globulin levels were significantly decreased. At baseline, serum OB levels in hypogonadal men were 3-fold elevated compared to those in normal men (12.39 +/- 2.93 micrograms/L vs. 4.28 +/- 0.52; P < 0.01) and not different between groups (TE, 13.7 +/- 5.6; TPEL, 11.3 +/- 2.9 micrograms/L). This elevation was retained after adjustment for body mass index in the normal control group [TE, 1.45 +/- 0.51 SD score (P < 0.0001); TPEL, 0.98 +/- 0.35 SD score (P < 0.0008)]. During T substitution serum OB was completely normalized (trough levels: TE, 4.6 +/- 1.0 micrograms/L; TPEL 4.3 +/- 0.9 micrograms/L). In multiple regression analysis, the androgen (T plus DHT)/estrogen ratio was the only significant determinant of OB levels (r = -0.32; P < 0.01). At baseline, OB levels did not correlate with body mass index, but during substitution, the correlation was considerably improved. We conclude that hypogonadal men exhibit elevated OB levels that are normalized by substitution with T. The only determinant of OB levels was the androgen/estrogen ratio, indicating a major influence of sex steroids on OB production. The interaction of T and OB might be part of a hypothalamic-pituitary-gonadal-adipose tissue axis that is involved in body weight maintenance and reproductive function.

Adult↗
PubMed1980

Monitoring the female reproductive cycle of great apes and other primate species by determination of oestrogen and LH in small volumes of urine.

A practical approach for monitoring the reproductive cycle of primates is described. Ovulation, implantation, gestation and post-partum amenorrhoea were identified from measurements of total immunoreactive oestrogen and LH bioactivity in incomplete daily urine samples collected from various species, including a gorilla, a chimpanzee and an orang-utan. Oestrogen values were determined by radioimmunoassay of hydrolysed urine using a non-specific oestriol antiserum and LH was assessed by measuring testosterone output from dispersed rat Leydig cells. Both hormone measurements were indexed by urinary creatinine levels to help adjust for differences in urine concentration and volume.

Animals↗
PubMed2006

Algorithmic reproduction of asymmetry and border cut-off parameters according to the ABCD rule for dermoscopy.

BACKGROUND: Semiquantitative algorithms were applied to dermoscopic images to improve the clinical diagnosis for melanoma. OBJECTIVE: The aim of the study was to develop a computerized method for automated quantification of the 'A' (asymmetry) and 'B' (border cut-off) parameters, according to the ABCD rule for dermoscopy, thus reproducing human evaluation. METHODS: Three hundred and thirty-one melanocytic lesion images, referring to 113 melanomas and 218 melanocytic nevi, acquired by means of a digital videodermatoscope, were considered. Images were evaluated by two experienced observers and by using computer algorithms developed by us. Clinical evaluation of asymmetry was performed by attributing scores to shape asymmetry and asymmetry of pigment distribution and structures, whereas computer evaluation of shape and pigment distribution asymmetries were based on the assessment of differences in area and lightness in the two halves of the image, respectively. Borders were evaluated both by clinicians and by the computer, by attributing a score to each border segment ending abruptly. Differences between nevus and melanoma values were evaluated using the chi-square test, while Cohen's Kappa index for agreement was employed for the evaluation of the concordance between human and computer. RESULTS: Pigment distribution asymmetry appears the most striking parameter for melanoma diagnosis both for human and for automated diagnosis. A good concordance between clinicians and computer evaluation was achieved for all asymmetry parameters, and was excellent for border cut-off evaluation. CONCLUSIONS: These algorithms enable a good reproduction of the 'A' and 'B' parameters of the ABCD rule for dermoscopy, and appear useful for diagnostic and learning purposes.

Algorithms↗
PubMedDate not supplied

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy.

OBJECTIVE: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. METHODS: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. RESULTS: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. CONCLUSIONS: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.

Adult↗
PubMed2000

Assessing the burden of sexual and reproductive ill-health: questions regarding the use of disability-adjusted life years.

The use of the disability-adjusted life year (DALY) as the unit in which to calculate the burden of disease associated with reproductive ill-health has given rise to considerable debate. Criticisms include the failure to address the problem of missing and inadequate epidemiological data, inability to deal adequately with co-morbidities, and lack of transparency in the process of ascribing disability weights to sexual and reproductive health conditions. Many of these criticisms could be addressed within the current DALY framework and a number of suggestions to do so are made. These suggestions include: (1) developing an international research strategy to determine the incidence and prevalence of reproductive ill-health and diseases, including the risk of long-term complications; (2) undertaking a research strategy using case studies, population-based surveillance data and longitudinal studies to identify, evaluate and utilize more of the existing national data sources on sexual and reproductive health; (3) comprehensively mapping the natural history of sexual and reproductive health conditions--in males and in females--and their sequelae, whether physical or psychological; (4) developing valuation instruments that are adaptable for both chronic and acute health states, that reflect a range of severity for each health state and can be modified to reflect prognosis; (5) undertaking a full review of the DALY methodology to determine what changes may be made to reduce sources of methodological and gender bias. Despite the many criticisms of the DALY as a measurement unit, it represents a major conceptual advance since it permits the combination of life expectancy and levels of dysfunction into a single measure. Measuring reproductive ill-health by counting deaths alone is inadequate for a proper understanding of the dimensions of the problem because of the young age of many of the deaths associated with reproductive ill-health and the large component of years lived with disability from many of the associated conditions.

Cost of Illness↗