Contraceptive use and sexual function: a comparison of Italian female medical students and women attending family planning services.

Objectives: The aims of the study were to understand how education relates to contraceptive choice and how sexual function can vary in relation to the use of a contraceptive method.Methods: We surveyed female medical students and women attending a family planning service (FPS) in Italy. Participants completed an online questionnaire which asked for information on sociodemographics, lifestyle, sexuality and contraceptive use and also included items of the Female Sexual Function Index (FSFI).Results: The questionnaire was completed by 413 women (362 students and 51 women attending the FPS) between the ages of 18 and 30 years. FSFI scores revealed a lower risk of sexual dysfunction among women in the control group who did not use oral hormonal contraception. The differences in FSFI total scores between the two study groups, when subdivided by the primary contraceptive method used, was statistically significant (p < 0.005). Women using the vaginal ring had the lowest risk of sexual dysfunction, compared with all other women, and had a positive sexual function profile. In particular, the highest FSFI domain scores were lubrication, orgasm and satisfaction, also among the control group. Expensive contraception, such as long-acting reversible contraception, was not preferred by this young population, even though such methods are more contemporary and manageable. Compared with controls, students had lower compliance with contraception and a negative attitude towards voluntary termination of pregnancy.Conclusion: Despite their scientific knowledge, Italian female medical students were found to need sexual and contraceptive assistance. A woman's sexual function responds to her awareness of her body and varies in relation to how she is guided in her contraceptive choice. Contraceptive counselling is an excellent means to improve female sexuality.

Multiple gut-liver axis abnormalities in children with obesity with and without hepatic involvement.

BACKGROUND: Gut-liver axis (GLA) dysfunction appears to play a role in obesity and obesity-related hepatic complications. OBJECTIVES: This study sought to concurrently explore several GLA components in a paediatric obese population with/without liver disease. METHODS: Thirty-two children (mean age 11.2 years) were enrolled: nine controls with normal weight and 23 patients with obesity (OB+). Of the 23 patients OB(+), 12 had not steatosis (ST-), and 11 had steatosis (ST+) (associated [n = 8] or not [n = 3] with hypertransaminasaemia [ALT +/-]). Subjects were characterized by using auxologic, ultrasonographic and laboratory parameters. A glucose hydrogen breath test was performed to test for small intestinal bacterial overgrowth, a urinary lactulose/mannitol ratio (LMR) was obtained to assess intestinal permeability, and tests for transaminases, blood endogenous ethanol, endotoxin and faecal calprotectin were also conducted. RESULTS: Eleven out of 23 patients OB(+) (p < 0.05) exhibited pathological (>90th percentile of the control group values) LMR, with values paralleling the grade of liver involvement (normal weight < OB[+] < OB[+]ST[+]ALT[-] < OB[+)]ST[+]ALT[+] [p < 0.05]). LMR significantly correlated with ethanolaemia (r = 0.38, p = 0.05) and endotoxaemia (r = 0.48, p = 0.015) concentrations. Increased permeability was a risk factor for the development of steatosis (p < 0.002). SIBO was present only in patients with obesity. Faecal calprotectin concentrations were within normal limits in all subjects. CONCLUSIONS: Increased permeability, endogenous ethanol and systemic endotoxin concentrations reflect some GLA dysfunction in obesity and its hepatic complications. Pending further results to establish their potential causative roles, the modulation of the GLA appears to represent a possible target for the prevention and treatment of these conditions.

Placental 11ß-Hydroxysteroid dehydrogenase type 2 expression: Correlations with birth weight and placental metal concentrations.

INTRODUCTION: Infants born below 2500 g are classified as low birth weight. Excess in utero exposure to cortisol has been linked to restricted fetal growth. Placental production of 11ß-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) inactivates cortisol before passage into the fetus. The present study tested the hypothesis that placental 11ß-HSD2 expression is positively correlated with an individualized birth weight centile and raw birth weight, and examines the relationship between metal concentrations in placental tissue and 11ß-HSD2 expression. METHODS: Placentae from 191 births were collected and samples preserved to maintain mRNA profile. Placental 11ß-HSD2 expression was measured via qRT-PCR. Addition samples were collected from placental tissues and uniformly dried in order to quantify 18 metals via ICP-MS (n = 160). RESULTS: A significant, positive correlation between 11ß-HSD2 expression and individualized birth weight centile (p = 0.0321) and birth weight (p = 0.0243) was found. Additionally, maternal age and gestational age were positivity correlated with each other (p = 0.0321). Birth weight was significantly different with race, marital status, education and maternal tobacco use. Four metals (Co, Mn, Ni, Zn) demonstrated significant positive correlations (p < 0.05) with 11ß-HSD2 expression. Sex specific differences were found; Co, Cu, Fe, Zn, and Ni were positively correlated with 11ß-HSD2 expression in males only, no significant correlations were found in the female only sample. CONCLUSION: These data indicate that the growth potential of a fetus is related to the 11ß-HSD2 expression in the placenta, and that 11ß-HSD2 expression is related to the trace metals status of the mother.

Placental concentrations of bisphenol A and birth weight from births in the Southeastern U.S.

INTRODUCTION: Bisphenol A (BPA) is a weakly estrogenic compound that has been detected in a wide variety of food products and biological matrices (saliva, blood, urine, etc). Despite the potential risk of human exposure to BPA, little information exists concerning maternal and fetal exposure to BPA during pregnancy. The aim of this study is to evaluate the correlation between placental BPA concentration, infant birth weight and calculated birth weight centile, and several other maternal and infant parameters. METHODS: Placental sample were collected from 200 subjects. BPA levels were measured by isotope dilution GC-MS. Additional maternal and infant data were gathered from medical charts and were potential correlates with placental BPA levels. RESULTS: Placental BPA concentrations ranged from 4.4 ng/g to 273.9 ng/g in oven-dried tissue (average 103.4 ± 61.8 ng/g). There was a significant negative correlation between calculated birth weight centile and levels of placental BPA (p < 0.05). Low birth weight and small for gestational age infants also had significantly greater placental BPA concentrations as compared to normal weight infants and average/large for gestational age infants. Infants born to African American mothers also had greater placental BPA concentrations as compared to infants born to Hispanic mothers. DISCUSSION: Placental BPA concentrations are correlated with the growth potential of the fetus and may play a role in reduced fetal growth.

Environmental pollution effects on reproductive health - clinical-epidemiological study in southern Italy.

UNLABELLED: This study aims to address the clinical, statistical and Epidemiological Relationship Between Birth Defects and Environmental Pollution, in the Campania Region and in Salerno. OBJECTIVES: WE EXAMINED FOUR GROUPS OF SUBJECTS AS FOLLOWS: a sample of pregnant women living in Salerno, a sample of pregnant women living in highly polluted areas, a sample of controls, pregnant women and residents out of the Campania Region, considered in unpolluted areas (Foggia) and in the Salerno area. METHODOLOGIES: a toxicological and genetic analysis was conducted on patients examined. CONCLUSIONS: there is an epidemiological link between environmental pollution and reproductive health in the Salerno area. Experimentally there are the first evidences of endocrine disruptors by the PCB. It has been inferred an overexpression of the mir-191 as a marker of pollution by dioxin-like compounds. Socially, correct information of populations at risk is necessary and a possible preventive and ongoing medical care must be ensured.

Training to provide for healthy rural aging.

More than 60 percent of the worlds aged population is in developing countries, the majority living in rural and remote areas. Resources in these areas are scarce and there is a lack of services and programs, especially in the areas of health, housing and social welfare. The most serious deficiency faced by many countries in meeting the challenges of population aging is the pronounced scarcity of trained caregivers. Little attention has been given to developing effective training policies and programs. Most of the people providing a service to older people lack basic training and this is more so in rural and remote areas. The processes for extending healthy aging and postponing the onset of chronic diseases and disabling conditions exist already. Unfortunately, these processes are not disseminated in appropriate ways. It is therefore imperative to disseminate this information by training people at the grass roots level to reach the most vulnerable and isolated older people. Primary care workers should have the necessary skills, knowledge and techniques to facilitate good care of older people in their environment. This article reviews and analyzes attempts being made by a number of countries to meet this need. Though the basic issues dealt with are often the same, the approach used differs.

Discriminative stimulus effects of diazepam and buspirone in normal volunteers.

A within-subject design was used to characterize the effects of dose manipulations on discriminative and self-reported effects of oral diazepam and buspirone. Subjects were trained to discriminate diazepam (10 mg) versus placebo (n = 10), or buspirone (10 or 15 mg) versus placebo (n = 9). The compounds were identified to subjects by letter code before discrimination training began. In later sessions, correct identifications at 2 hr after the oral administration of drug earned money. All subjects showed accurate discrimination performance during the test-of-acquisition phase. In a low-dose generalization phase, diazepam and buspirone produced dose-related increases in drug identifications across a four-fold range of doses. In a subsequent low-dose training phase, in which subjects were trained to discriminate progressively lower drug doses, the median lowest discriminable dose of diazepam and buspirone was 2.5 and 7.5 mg, respectively. Dose-response functions for drug identifications were shifted leftward in the low-dose training phase relative to the low-dose generalization phase, suggesting that reinforcement of progressively lower doses enhances drug discriminability. The self-reported effects of diazepam and buspirone were similar (e.g., both drugs increased ratings of drug strength and clumsy/uncoordinated) and different (e.g., diazepam but not buspirone increased ratings of drowsy/sleepy; buspirone but not diazepam increased ratings of tense/nervous). This study demonstrates discriminative and self-reported effects of diazepam and buspirone at doses lower than previously shown to be behaviorally active, and suggests that at commonly used clinical doses, diazepam is relatively more discriminable than buspirone.

Tandospirone and alprazolam: comparison of behavioral effects and abuse liability in humans.

Tandospirone is a novel nonbenzodiazepine anxiolytic/antidepressant that acts primarily at the serotonin-1A receptor. In the present study, the behavioral effects and abuse liability of tandospirone were characterized relative to those of the benzodiazepine, alprazolam. In an outpatient setting, the acute effects of placebo, tandospirone citrate (40, 80 and 160 mg) and alprazolam (0.5, 1.0 and 2.0 mg) were assessed with a double-blind, cross-over design in 14 male volunteers with histories of sedative drug abuse. Drug effects were assessed on behavioral performance tasks; observer ratings of drug effect; and subject ratings of strength of drug effect, mood and drug liking. Both alprazolam and tandospirone produced comparable dose-related increases in subject- and observer-rated strength of drug effect. The peak drug effect occurred approximately 2 hr after drug administration; the time to peak did not differ between the two drugs. Alprazolam produced greater impairments on psychomotor performance than did tandospirone. Alprazolam produced dose-related increases in subject-rated drug liking; tandospirone, in contrast, produced dose-related increases in subject-rated drug disliking. The highest dose of alprazolam was predominantly classified by subjects as being a benzodiazepine or a barbiturate (71%) in contrast to the highest dose of tandospirone (29%). Across subjects, tandospirone plasma concentrations after a single dose of 160 mg were significantly correlated with several subjective and behavioral measures. The present study demonstrates that tandospirone and alprazolam can be clearly differentiated on the basis of subjective effects and performance measures. The overall profile indicates that tandospirone has a significantly lower abuse liability than does alprazolam.

Multiple-choice procedure: an efficient approach for investigating drug reinforcement in humans.

Two experiments demonstrated the efficiency of assessing drug reinforcement in humans by using a novel multiple-choice procedure. The distinguishing characteristic of the procedure is that it arranges intermittent reinforcement for choices between pairs of potential reinforcers. The procedure has three key operations: (1) a subject is exposed to the potential reinforcers; (2) a subject then makes two or more choices on a questionnaire; for each choice, the subject is required to choose one of two potential reinforcers (e.g. drug vs. drug choices and/or drug vs. money choices); and (3) subsequently only one of the choices, randomly selected, is reinforced. In the present experiments, two variations of the multiple-choice procedure were evaluated in twelve male drug abusers. Both experiments assessed the reinforcing effects of three drug conditions (200 and 400) mg/70kg pentobarbital and placebo) which were presented no more often than every to other day. The experiments demonstrated dose-related choice of pentobarbital over money as well as choice of a higher dose of pentobarbital over a lower dose or placebo. Orderly data were generated with a single-session exposure to each drug condition. Multiple-choice procedures should have applicability, not only to the investigation of drug reinforcement, but also to the study of non-drug reinforcement in humans.

Reduction of learned helplessness by central administration of quaternary naltrexone.

Prior research has established that escape impairment resulting from prior inescapable shock (IS) could be reversed by the peripheral administration of the opiate antagonist naltrexone (NTX), but not the quaternary form of naltrexone (QNTX), which when systemically administered, does not readily pass the blood-brain barrier. As it was unclear whether the failure of systemically administered QNTX to reduce shuttle escape deficits following exposure to IS could be attributed to reasons other than the restricted access of QNTX to receptor sites in the brain, rats were affixed with chronic indwelling ventricular cannulae to allow direct brain administration of QNTX. The present experiment found a significant attenuation of the escape deficit produced by prior inescapable shock following the intracerebroventricular (ICV) administration of QNTX (10 micrograms/rat). These data provide further evidence of a mediational role for central opiate receptors in the expression of escape interference following inescapable shock.