TNFα Variation During the Menstrual Cycle and Thereafter: A New Explanation for Gender-Based Disparities in ICU Admission Rates, Trauma Outcomes, and General Mortality.

BACKGROUND: Multiple studies have found gender-based disparities in intensive care unit (ICU) admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions. METHODS: Six older than 60 years old volunteers in both genders, 40 young female volunteers (no contraceptive drug, n = 18, contraceptive drug, n = 9, lactation, n = 9, pregnant, n = 4) were collected with following exclusion criteria, malignant disease, inflammation, infection, trauma and taking non-steroid anti-inflammatory drugs and antibiotics. Females were studied on days 1 and 14 of cycle. Serum TNFα was determined by HS TNF ELISA. Female hormones were also determined. RESULTS: Serum TNFα, estradiol, and progesterone individual values in volunteers with cycle (no contraceptive drug) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14.Serum TNFα, estradiol, and progesterone individual values in volunteers with no cycle (contraceptive drug yes) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14; furthermore, seemingly lower estradiol values on day 1 and day 14 between groups can be seen. A significant decrease was demonstrated in serum progesterone values on day 14 of group with contraceptive drug compared with group with no contraceptive one.A significant negative correlation is demonstrated between serum progesterone and serum TNFα values on day 14.A marked significant difference in serum TNFα values between volunteers with cycle and with no cycle, like contraceptive, lactation pregnancy (trimesters P1, P2, P3), and climax. CONCLUSION: For homogenous group of female patients not the gender and age are important but the cycle itself.

From alga to omega; have we reached peak (fish) oil?

SummaryWhile the Inuit diet was highly cardio-protective and consuming oily fish within a Western diet is to a lesser degree, the case for purified fish oil supplements is less convincing. Purification of fish oil removes lipophilic polyphenols which likely contribute to the health benefits of oily fish; leaving the ω3 highly unsaturated fatty acids exposed and prone to conferring oxidative and inflammatory stress. The authors believe that due to such issues as dietary shift, it may now be inadvisable to prescribe or sell purified ω3 highly unsaturated fatty acids supplements, unless the appropriate co-factors are included.

[Management of hereditary ovarian cancer]. / A családi halmozódású petefészekrák genetikai és onkológiai ellátása.

Mutations in BRCA1 and BRCA2 genes account for the majority of hereditary breast and ovarian cancers. Approximately 10% of cases of ovarian cancer are due to germline mutations in BRCA1 and BRCA2. Ovarian cancer associated with BRCA1 and BRCA2 mutations has a distinct histological phenotype. This type of cancer is predominantly of serous or endometrioid histology and is high grade. Patients with BRCA1 or BRCA2 mutations should be offered risk-reducing salpingo-oophorectomy by age 40 years, or when childbearing is complete. Nowadays there are no differences between the treatments provided for sporadic and hereditary ovarian cancer, although there are indications that targeted therapy is effective in women with BRCA1/BRCA2-associated tumors. Retrospective studies reveal a high level of sensitivity to platinum agents in BRCA-associated tumors and initial trials show good efficacy and tolerability for polyADP-ribose polymerase inhibitors in mutation carriers with advanced ovarian cancers. These agents might also potentially be used in chemoprevention. Authors review the current management of hereditary ovarian cancer.