Are there differences in symptoms experienced by midlife climacteric women with and without metabolic syndrome? A scoping review.

INTRODUCTION: Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome. METHODS: A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria. RESULTS: The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters. CONCLUSION: Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions.

Regulation of B cell activating factor (BAFF) receptor expression by NF-ΚB signaling in rheumatoid arthritis B cells.

B cells play an important role in the pathogenesis of rheumatoid arthritis (RA). High levels of B cell activating factor (BAFF) are detected in autoimmune diseases. BAFF and BAFF receptor (BAFF-R) are expressed in B and T cells of RA synovium. The study was undertaken to identify the NF-ΚB signal pathway involved in the induction of BAFF-R in human B cells. Immunohistochemical staining of NF-ΚB p65, NF-ΚB p50, BAFF, and BAFF-R was performed on sections of synovium from severe and mild RA and osteoarthritis (OA) patients. Peripheral blood mononuclear cells (PBMCs) were isolated from control and RA patients and B cells were isolated from controls. BAFF-R was analyzed by flow cytometry, realtime PCR and confocal staining after treatment with NF-ΚB inhibitors. NF-ΚB p65, NF-ΚB p50, BAFF, and BAFF-R were highly expressed in severe RA synovium relative to mild RA synovium or OA synovium. BAFF-R expression was reduced by NF-ΚB inhibitors in PBMCs and B cells from normal controls. We also showed reduction in expression of BAFF-R via inhibition of the NF-ΚB pathway in PBMCs of RA patients. BAFF/BAFF-R signaling is an important mechanism of pathogenesis in RA and that BAFF-R reduction by NF-ΚB blocking therapy is another choice for controlling B cells in autoimmune diseases such as RA.

Choice of solvent (MeCN vs H(2)O) decides rate-limiting step in S(N)Ar aminolysis of 1-fluoro-2,4-dinitrobenzene with secondary amines: importance of Brønsted-type analysis in acetonitrile.

A kinetic study is reported for nucleophilic substitution reactions of 2,4-dinitro-1-fluorobenzene (DNFB) with a series of secondary amines in MeCN and H2O at 25.0 degrees C. The reaction in MeCN results in an upward curvature in the plot of k(obsd) vs [amine], indicating that the reaction proceeds through a rate-limiting proton transfer (RLPT) mechanism. On the contrary, the corresponding plot for the reaction in H2O is linear, implying that general base catalysis is absent. The ratios of the microscopic rate constants for the reactions in MeCN are consistent with the proposed mechanism, e.g., the facts that k2/k(-1) < 1 and k3/k2 > 10(2) suggest that formation of a Meisenheimer complex occurs before the rate-limiting step and the deprotonation by a second amine molecule becomes dominant when [amine] > 0.01 M, respectively. The Brønsted-type plots for k1k2/k(-1) and k1k3/k(-1) are linear with betanuc values of 0.82 and 0.84, respectively, which supports the proposed mechanism. The Brønsted-type plot for the reactions in H2O is also linear with betanuc = 0.52 which has been interpreted to indicate that the reaction proceeds through rate-limiting formation of a Meisenheimer complex. DNFB is more reactive toward secondary amines in MeCN than in H2O. The enhanced basicity of amines as well as the increased stability of the intermediate whose charges are delocalized through resonance are responsible for the enhanced reactivity in the aprotic solvent.