Association between nutritional level, menstrual-related symptoms, and mental health in female medical students.

OBJECTIVE: Research suggests that medical students as well as women are at greater risk of depression compared to the general population and men. This suggests that female medical students are crucial targets requiring specific monitoring for mental health disorder prevention and intervention. However, little is known regarding the risk factors for poor mental health among this population. Therefore, we investigated whether menstrual symptoms and nutritional status are associated with psychological distress in Japanese female medical students. METHODS: This cross-sectional study assessed 326 female medical students who attended a school medical check-up, which included blood sampling in 2018. The levels of psychological distress were evaluated using the Japanese General Health Questionnaire (J-GHQ)-30. We defined high GHQ scores as GHQ-30 ≥7. We checked dysmenorrhea levels and assessed menstrual symptoms according to the presence of premenstrual syndrome (PMS). Dysmenorrhea was evaluated according to quartiles of the sum of the Menstrual Distress Questionnaire (MDQ). PMS was assessed using the Premenstrual Symptoms Questionnaire (PSQ). We evaluated levels of serum albumin, hemoglobin, ferritin, and lipid metabolite as nutritional factors. A multivariate logistic regression analysis was used to identify the association between menstrual-related symptoms or nutritional factors and the levels of psychological distress. RESULTS: A total of 45 female medical students (15%) experienced psychological distress. Serum albumin levels were associated with psychological distress, while lipid metabolite levels were not. The intensity of dysmenorrhea and the presence of PMS were associated with psychological distress, independent of nutritional status. CONCLUSION: Both menstrual symptoms and nutrition markers were associated with the levels of psychological distress in Japanese female medical students. School doctors and nurses can help improve the mental health of young female medical students by encouraging a healthy diet and checking for the presence of menstrual symptoms.

Association of aortic root dilatation with left ventricular function in patients with postoperative ventricular septal defect.

Proximal aortic enlargement is associated with an increased risk of heart failure and all-cause mortality. Recently, aortic root dilatation (ARD) was reported in postoperative patients with ventricular septal defects (VSDs). However, the impact of ARD on left ventricular (LV) function in postoperative VSD patients remains unclear. Thus, the aim of this study was to investigate the effect of ARD on LV function in patients with postoperative VSD. One hundred and thirty-five patients (> 15 years of age) with surgically repaired isolated ventricular defects and who underwent transthoracic echocardiography in our institution between 2009 and 2013 were identified. ARD was defined as an observed aortic root diameter/body surface area > 2.1 cm/m2. The propensity score estimating the probability of having ARD adjusted for anatomical and clinical characteristics was calculated. Forty-four patients (32.6%) had ARD. In unadjusted analyses, right ventricular systolic pressure, Tei index, and E/e' were significantly (p < 0.05) higher in patients with ARD than in those without ARD (31.3 ± 7.5 vs. 35.4 ± 13.7 mmHg, 0.32 ± 0.10 vs. 0.44 ± 0.15, and 7.1 ± 1.7 vs. 9.5 ± 2.9, respectively). In the propensity score-adjusted analysis, significant differences in the Tei index and E/e' were confirmed between the two groups (Tei index difference: 0.11, 95% confidence interval 0.05-0.17; E/e' difference: 2.4, 95% confidence interval 1.3-3.5). However, there were no differences in the other echocardiographic measurements. The presence of ARD in patients with postoperative VSD was significantly associated with LV diastolic dysfunction. Thus, surgically repaired VSD patients require careful screening for aortic enlargement and LV function.

Sexual Violence as a Key Contributor to Poor Mental Health Among Japanese Women Subjected to Intimate Partner Violence.

OBJECTIVES: The aim of this study was to examine the impact of sexual intimate partner violence (IPV) on mental health among Japanese women and to explore to what extent sexual IPV is an important contributor to the severity of mental health problems in comparison with physical and psychological IPV. MATERIALS AND METHODS: A cross-sectional analysis was conducted of the medical records of participants during psychiatric consultation at the Institute of Women's Health, Tokyo Women's Medical University, including 62 women who experienced IPV without sexual violence and 83 women who experienced IPV with sexual violence. Mental health problems were compared, including anxiety, depression, suicidality, post-traumatic stress disorder (PTSD), and dissociative experiences. RESULTS: The results demonstrated a higher incidence and severity of somatic symptoms, insomnia, social dysfunction, severe depression and suicidality, PTSD, and dissociative experiences among women in the sexual IPV group than in the women who experienced IPV without sexual violence. In analyzing the relative contribution of sexual, physical, and psychological violence to the severity of mental health problems of the survivors, results indicated that sexual violence was an independent predictor of both PTSD and dissociative experiences. CONCLUSIONS: The present research showed that significant adverse effects on mental health were observed among women who experienced IPV with sexual violence compared with the ones without. These findings provide important implications for considering the specific approaches to meet the needs of those women experiencing sexual IPV and the need for timely and effective interventions, including healthcare, social services, and primary prevention.

Heparin regulates transcription of endothelin-1 gene in endothelial cells.

Heparin, which is widely used as an anticoagulant, has been shown to have antiatherosclerotic and antihypertensive effects in animals and humans. These effects are mediated by the inhibition of endothelin-1 (ET-1) production in endothelial cells. To clarify the mechanism of this inhibition, we investigated the effect of heparin on transcriptional regulation of the ET-1 gene in bovine aortic endothelial cells (BAEC) cultured in fetal calf serum. ET-1 mRNA expression was significantly suppressed by heparin in a dose-dependent manner. Promoter analysis revealed that the minimum ET-1 promoter containing only the GATA and AP-1 sequences as positive cis-acting sites in the ET-1 promoter is sufficient for this suppression. Gel mobility shift assays using oligonucleotides encoding the ET-1 AP-1 and ET-1 GATA sites confirmed that both AP-1 and GATA binding activities in BAEC nuclear extract were markedly inhibited by heparin. Western blot analyses indicated that heparin completely blocked extracellular signal-regulated kinase (ERK) activation, and inhibiting ERK activity resulted in loss of heparin-dependent inhibition of the ET-1 gene. These data indicate that the ET-1 mRNA level is negatively regulated by heparin at the transcription level, through modification of AP-1 and GATA protein binding activities, which direct the ET-1 promoter in BAEC. This effect may be mediated, at least in part, through inhibition of ERK activity.