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.

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study.

OBJECTIVE: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause. SUBJECTS: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. METHODS: Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year. RESULTS: Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73). CONCLUSIONS: This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

Nucleolar organizer regions: a prognostic factor in infiltrating ductal carcinoma in the breast.

By means of an AgNOR technique, the authors have carried out a retrospective study on proliferative activity in 170 cases of infiltrating ductal breast carcinoma (so-called carcinoma NOS). The follow-up period was 138 months. A statistically significant correlation was found between AgNOR score and outcome of the disease ("vital status"), clinical stage and OS respectively. By means of discriminant analysis a threshold value of AgNOR score was identified (= 9.5) which distinguished two risk groups among the cases under examination. Those cases with an average AgNOR score below the threshold value showed a favourable prognosis. The cases with an AgNOR score greater than 9.5 had an unfavourable outcome. The authors suggest that AgNOR score may be used as a prognostic parameter in breast carcinoma.

Metacarpophalangeal joint motion and the role of the collateral ligaments.

A three stage study of the metacarpophalangeal joint was performed. First, a triaxial goniometer was designed which allowed direct measurement of joint motion in living and cadaveric hands. Then, based on the above data, a computer simulated model of the joint was developed. This permitted an analysis of the orientation of the joint for any given point in the axis of motion, the effects of the collateral ligaments and their contribution to joint motion and stability. Finally the metacarpal head was analysed using a shadow profilometer and anatomical dissections. From 0 degree to 70 degrees, the metacarpal head demonstrated a curved configuration. At approximately 70 degrees, the metacarpal head assumed a bicondylar shape which produced a bony block to lateral deviation. Dissection of the collateral ligaments demonstrated that they ran diagonally from the metacarpal head to the proximal phalanx. We conclude that the metacarpophalangeal joint has an instant axis. From 0 degree to 70 degrees of flexion, in any given hand, the angle of lateral deviation is constant. Beyond 70 degrees there is a marked decrease in lateral deviation. The joint has two degrees of freedom and the collateral ligament is taut in all positions.

Kinematic analysis of the role of the finger tendons.

In an earlier paper (Storace and Wolf, 1979), the functional anatomy of the finger was studied by considering the equilibrium of tendon forces and externally applied forces. The current work presents an alternative approach which studies the finger's functional anatomy from a kinematic viewpoint. This approach, based on measured tendon displacement, can be used to graphically display the criteria for which normal finger function will exist. Examples of the application of this procedure to normal and non-normal finger conditions are presented to demonstrate its utility.

Detailed anatomy of the extensor mechanism at the proximal aspect of the finger.

To explain the unique action of the lateral bands during flexion and extension of the finger, a study was undertaken to examine the extensor mechanism at the level of the proximal interphalangeal joint. The study was carried out in three stages-histologic, anatomic, and dynamic. The histologic sections showed no elastic tissue present to account for the expansile and contractile movement of the lateral bands. The anatomic and dynamic studies showed that the extensor mechanism at the level of the proximal aspect of the finger was composed of an intricate, layered, crisscross fiber pattern which altered its geometric arrangement as the finger was flexed and extended. It is our opinion that the action of the crisscross fibers may govern both the action and degree of displacement of the lateral bands during flexion and extension of the finger.

Biochemical and electron microscopic evidence that cell nucleus negatively controls mitochondrial genomic activity in early sea urchin development.

Enucleated halves of sea urchin eggs obtained by centrifugation contain almost all the mitochondrial population of the egg. Removal of the nucleus followed by parthenogenetic activation stimulates the incorporation of [3H]thymidine into the mitochondrial DNA, whereas no such incorportion is observed in activated whole eggs. The block is not the result of a modification in the permeability of the mitochondrial membrane. Electron microscopic observations demonstrated duplication of mitochondrial DNA molecules in activated enucleated halves. No duplication was found in the mitochondrial DNA from activated whole eggs or from nonactivated enucleated halves. We conclude that the cell nucleus exerts a negative control on the activity of the mitochondrial genome through some short-lived nuclear substance(s).