An exploration of secondary sex ratios among women diagnosed with anxiety disorders.

BACKGROUND: Theory suggests that natural selection conserved reactivity in part because highly reactive women spontaneously abort less fit conceptuses, particularly small males. Other literature argues that high reactivity manifests clinically as anxiety disorders. If true, births to women diagnosed with anxiety disorders should exhibit a low secondary sex ratio (i.e. ratio of male to female births). We explored whether births to women diagnosed with anxiety disorders exhibit a lower sex ratio than births to women diagnosed with other psychiatric disorders, or to women without mental health diagnoses. METHODS: We performed a case-control comparison of the secondary sex ratios among groups of women categorized by mental health diagnosis using birth records linked to data from California County Mental Health system records. We compared sex ratios among 5994 deliveries to mothers diagnosed with anxiety disorders, 23 443 deliveries to mothers diagnosed with other psychiatric disorders and 1 099 198 'comparison' births. RESULTS: Although comparison births exhibited a higher sex ratio than births to women diagnosed with anxiety disorders or with other diagnoses, differences were not statistically significant. Births to African American women diagnosed with anxiety disorders, however, exhibited sex ratios significantly lower than comparison births among African Americans (OR = 0.89, P = 0.038) or births to African American women with other mental health diagnoses (OR = 0.88, P = 0.042). CONCLUSIONS: We found that infants born to African American women diagnosed with anxiety disorders exhibited a significantly lower secondary sex ratio than reference groups. We urge confirmatory tests of our findings and discuss implications of the reactivity/anxiety hypothesis for psychiatry, obstetrics and public health.

The femoral cement mantle in three total hip replacements.

We measured the size and volume of the femoral broaches and stems supplied with three commercial total hip replacement (THR) systems (JRI Furlong, Biomet Stanmore, and Howmedica Exeter). Using an in vitro method, we created cement mantles that could be directly measured. The broaches supplied with the Biomet Stanmore and the Howmedica Exeter systems allowed the creation of significantly thicker cement mantles than the JRI broaches and stems (Stanmore mean thickness = 1.7 mm, defects at 3% of measurement sites; Exeter mean thickness = 2.0 mm, no defects; JRI mantles mean thickness = 0.9 mm, cement defects at 29% of measurement sites). We conclude that, in vivo, the broaches supplied with the Stanmore and Exeter systems are significantly larger than the corresponding stems, and will excavate a cavity large enough to accommodate the appropriate femoral stem surrounded by an intact cement mantle.

Tendo Achillis rupture; surgical repair is a safe option.

We reviewed the results of 67 tendo Achillis repairs performed at one District General Hospital over a 5-year period, using details from a comprehensive database. At a mean follow-up of 2.5 years, the re-rupture rate was 3% (2 out of 67). The infection rate was 1.5% (1 out of 67). A review of the relevant literature has revealed that quoted infection rates following tendo Achillis repair vary considerably, and are as high as 21%. Several authors have advised against repair based on those data. In the light of our results, we can recommend surgical repair of tendo Achillis rupture as a safe option.

Complications of a simple procedure: de Quervain's disease revisited.

We reviewed the results of 22 operations performed on 21 patients for the relief of de Quervain's disease over the last six years. At a mean follow-up of 34 months (range 4-78 months), 18 of 22 wrists had complete relief of their original symptoms. One patient required reoperation because of inadequate decompression, and two others await further surgery. Most operations (14 out of 22) were performed under local anaesthesia, and 17 out of 22 used a longitudinal incision. The use of a longitudinal incision was associated with a significant risk of complications: four patients had a poor cosmetic result, and six showed evidence of superficial radial nerve injury. Two patients had a wound infection, and one developed reflex sympathetic dystrophy. Although surgical decompression for de Quervain's disease is effective in curing the symptoms in most patients, using a longitudinal incision is associated with poor wound healing and damage to the terminal branches of the radial nerve.

Interactions between oestradiol and epidermal growth factor in endometrial stromal proliferation and differentiation.

The relationship between oestradiol and epidermal growth factor (EGF) in the control of endometrial proliferation and differentiation in cultures of human endometrial stromal cells was investigated. Oestradiol at a concentration of 10 nmol l-1 increased the incorporation of both [3H]thymidine and [3H]leucine but the differences were significantly different from control only for [3H]leucine incorporation. Concentrations of 0.16, 1.6 and 16 nmol EGF l-1 significantly increased both [3H]thymidine (P < 0.01) and [3H]leucine incorporation (P < 0.01). The pure steroidal antioestrogen, ICI 182,780, inhibited any increase in [3H]thymidine and [3H]leucine incorporation stimulated by oestradiol in endometrial stroma. The monoclonal antibody, ICR 16, directed against the EGF receptor did not inhibit the oestradiol action in stromal cells, indicating that, in this model system, oestradiol does not act by inducing synthesis or release of EGF. However, ICI 182,780 potently inhibited the incorporation of [3H]thymidine stimulated by EGF in endometrial stromal cells, suggesting interdependence between oestradiol and EGF in the control of endometrial stromal proliferation. Oestrogen-free conditioned medium from endometrial stromal cultures did not stimulate either [3H]thymidine or [3H]leucine incorporation, suggesting that oestradiol did not stimulate the secretion of a trophic factor from endometrial stromal cells.

The actions of estradiol and epidermal growth factor in endometrial and endometriotic stroma in vitro.

OBJECTIVES: To compare the effects of E2 and epidermal growth factor (EGF) on DNA and protein synthesis in endometrial and endometriotic stromal cell culture. DESIGN: Measurement of DNA and protein synthesis in cell cultures by trichloroacetic acid precipitation of radioactively labeled macromolecules. SETTING: Tissue samples collected in operating theaters were processed in the cell culture laboratory. PATIENTS: Samples of endometrium and endometriosis were collected synchronously at laparotomy. INTERVENTIONS: Stromal cells were isolated from tissue samples. Cultures of endometrial and endometriotic stromal cells were treated with 0.272 ng/mL (1 nmol/L) E2 or 10 ng/mL (1.6 nmol/L) EGF. MAIN OUTCOME MEASURES: 3H-Thymidine and 3H-leucine incorporation were used to assess DNA and protein synthesis respectively in cell cultures. RESULTS: There was no response to 0.272 ng/mL (1 nmol/L) E2 with respect to DNA or protein synthesis in either endometrial or endometriotic stromal cells, whereas 10 ng/mL (1.6 nmol/L) EGF significantly stimulated DNA and protein synthesis in both cell types. The effect of EGF was significantly greater in endometrial stroma than in endometriotic stroma. CONCLUSIONS: There are differences in the stimulation of 3H-thymidine incorporation by 10 ng/mL (1.6 nmol/L) EGF in endometrial and endometriotic stromal cells in vitro.

Developmental changes in the type I procollagen processing pathway in chick-embryo cornea.

Type I procollagen processing in chick-embryo corneas was studied at days 12, 14 and 17 of development. Pulse-chase experiments and electrophoretic analysis of salt-soluble extracts showed developmental changes in the processing pathway. A kinetic model was fitted to the data to determine rate constants for processing of both N- and C-propeptides. Data for pro alpha 1(I)-chain processing and pro alpha 2(I)-chain processing were fitted separately (where pro means procollagen). Between days 12 and 17 the relative flux through the pC-collagen (procollagen chain lacking the N-propeptide) and pN-collagen (procollagen chain lacking the C-propeptide) pathways increased approx. 4-fold. Pro alpha 1(I) chains and pro alpha 2(I) chains were processed by slightly different routes. Variations in the rate constants were compared with electron-microscopic measurements of collagen fibril diameters at each stage of development. Diameters increased by less than 10% over the period from 12 to 17 days. It was concluded that fibril diameters are relatively insensitive to the pathway of procollagen processing in the salt-soluble pool.