Increased genital mucosal cytokines in Canadian women associate with higher antigen-presenting cells, inflammatory metabolites, epithelial barrier disruption, and the depletion of L. crispatus.

BACKGROUND: Cervicovaginal inflammation has been linked to negative reproductive health outcomes including the acquisition of HIV, other sexually transmitted infections, and cervical carcinogenesis. While changes to the vaginal microbiome have been linked to genital inflammation, the molecular relationships between the functional components of the microbiome with cervical immunology in the reproductive tract are understudied, limiting our understanding of mucosal biology that may be important for reproductive health. RESULTS: In this study, we used a multi'-omics approach to profile cervicovaginal samples collected from 43 Canadian women to characterize host, immune, functional microbiome, and metabolome features of cervicovaginal inflammation. We demonstrate that inflammation is associated with lower amounts of L. crispatus and higher levels of cervical antigen-presenting cells (APCs). Proteomic analysis showed an upregulation of pathways related to neutrophil degranulation, complement, and leukocyte migration, with lower levels of cornified envelope and cell-cell adherens junctions. Functional microbiome analysis showed reductions in carbohydrate metabolism and lactic acid, with increases in xanthine and other metabolites. Bayesian network analysis linked L. crispatus with glycolytic and nucleotide metabolism, succinate and xanthine, and epithelial proteins SCEL and IVL as major molecular features associated with pro-inflammatory cytokines and increased APCs. CONCLUSIONS: This study identified key molecular and immunological relationships with cervicovaginal inflammation, including higher APCs, bacterial metabolism, and proteome alterations that underlie inflammation. As APCs are involved in HIV transmission, parturition, and cervical cancer progression, further studies are needed to explore the interactions between these cells, bacterial metabolism, mucosal immunity, and their relationship to reproductive health. Video Abstract.

Hypertension and hypertension severity in Hispanics/Latinx with MS.

BACKGROUND: Vascular comorbidities (VCs) including hypertension (HTN) are associated with worse multiple sclerosis (MS) outcomes. HTN is common in Latinx, but the prevalence and relationship with disability are unknown in Latinx with MS. METHODS: Latinx (n = 451) from the Alliance for Research in Hispanic MS (ARHMS) seen between 2007 and 2019 were included. HTN, diabetes (DM), hyperlipidemia (HLD), ischemic events, and smoking were considered VC. Blood pressures (BPs) were classified using the American Heart Association (AHA) criteria. Logistic regression determined associations between VC and ambulatory disability accounting for age, sex, and disease duration. RESULTS: Medical comorbidities were found in 41.9% and VC in 24.2%. Smoking (13.6%) and HTN (7.3%) were the most common. HTN was the most common over the age of 40 (12.6%). The odds of having severe disability were three times higher for those with HTN (odds ratio [OR], 3.12; 95% confidence interval (CI), 1.37-7.12). Stage II HTN according to AHA also tripled the odds (OR, 2.89; 95%CI, 1.11-7.55). AHA BP confirmed HTN in 27.5% (compared to 7.3% with established diagnosis). CONCLUSION: HTN diagnosis and stage II HTN defined by AHA were independently associated with severe ambulatory disability in Latinx with MS. HTN was underdiagnosed. Future studies should assess whether HTN treatment control would prevent disability in MS.

Rectal Perforation by an Intrauterine Device Leading to Fatal Intra-Abdominal Sepsis and Necrotizing Fasciitis.

BACKGROUND: Colorectal injury from an intrauterine device (IUD) is rare but may lead to major complications. CASE: A 55-year-old woman presented to a tertiary care hospital with 4 days of generalized weakness, confusion, dysuria, and lower back pain. She provided a vague history of an unsuccessful attempt to remove an IUD 30 years prior. A computed tomography scan demonstrated an IUD in the rectal lumen, with gluteal and pelvic gas and fluid collections. Emergency surgery found necrotizing fasciitis. Despite multiple debridements, sigmoidoscopic IUD removal, and long-term intravenous antibiotics, the patient died from sepsis and multiorgan failure. CONCLUSION: IUDs require proper monitoring and timely removal to prevent potential complications associated with organ perforation.

Preliminary observations on high energy phosphates and metabolic pathway and transporter potentials in extensor carpi radialis brevis and trapezius muscles of women with work-related myalgia.

This study compared both the extensor carpi radialis brevis (ECRB) and the trapezius (TRAP) muscles of women with work-related myalgia (WRM) with healthy controls (CON) to determine whether abnormalities existed in cellular energy status and the potentials of the various metabolic pathways and segments involved in energy production and substrate transport. For both the ECRB (CON, n = 6-9; WRM, n = 13) and the TRAP (CON, n = 6-7; WRM, n = 10), no differences (P > 0.05) were found for the concentrations (in millimoles per kilogram of dry mass) of ATP, PCr, lactate, and glycogen. Similarly, with one exception, the maximal activities (in moles per milligram of protein per hour) of mitochondrial enzymes representative of the citric acid cycle (CAC), the electron transport chain (ETC), and ß-oxidation, as well as the cytosolic enzymes involved in high energy phosphate transfer, glycogenolysis, glycolysis, lactate oxidation, and glucose phosphorylation were not different (P > 0.05). The glucose transporters GLUT1 and GLUT4, and the monocarboxylate transporters MCT1 and MCT4, were also normal in WRM. It is concluded that, in general, abnormalities in the resting energy and substrate state, the potential of the different metabolic pathways and segments, as well as the glucose and monocarboxylate transporters do not appear to be involved in the cellular pathophysiology of WRM.

Excitation-contraction coupling properties in women with work-related myalgia: a preliminary study.

We investigated the potential role of selected excitation-contraction coupling processes in females with work-related myalgia (WRM) by comparing WRM with healthy controls (CON) using tissue from extensor carpi radialis brevis (ECRB) and trapezius (TRAP) muscles. For the ECRB, age (mean ± SE) was 29.6 ± 3.5 years for CON (n = 9) and 39.2 ± 2.8 years for WRM (n = 13), while for the TRAP, the values were 26.0 ± 2.1 years for CON (n = 7) and 44.6 ± 2.9 years for WRM (n = 11). For the sarcoplasmic reticulum (SR) of the ECRB, WRM displayed concentrations (nmol·(mg protein)(-1)·min(-1)) that were lower (P < 0.05) for Total (202 ± 4.4 vs 178 ± 7.1), Basal (34 ± 1.6 vs 30.1 ± 1.3), and maximal Ca(2+)-ATPase activity (Vmax, 168 ± 4.9 vs 149 ± 6.3), and Ca(2+)-uptake (5.06 ± 0.31 vs 4.13 ± 0.29), but not SERCA1a and SERCA2a isoforms, by comparison with CON. When age was incorporated as a co-variant, Total, Basal, and Ca(2+)-uptake remained different from CON (P < 0.05), but not Vmax (P = 0.13). For TRAP, none of the ATPase properties differed between groups (P > 0.05) either before or following adjustment for age. No differences (P > 0.05) were observed between the groups for Ca(2+)-release in the SR for either TRAP or ECRB. Similarly, no deficiencies, regardless of muscle, were noted for either the Na(+)-K(+)-ATPase content or the α and ß subunit isoform distribution in WRM. This preliminary study provides a basis for further research, with expanded numbers, investigating the hypothesis that abnormalities in SR Ca(2+)-regulation are involved in the cellular etiology of WRM.

Role of exercise duration on metabolic adaptations in working muscle to short-term moderate-to-heavy aerobic-based cycle training.

This study aimed at investigating the relative roles of the duration versus intensity of exercise on the metabolic adaptations in vastus lateralis to short-term (10 day) aerobic-based cycle training. Healthy males with a peak aerobic power (VO2 peak) of 46.0 ± 2.0 ml kg(-1) min(-1) were assigned to either a 30-min (n = 7) or a 60-min (n = 8) duration performed at two different intensities (with order randomly assigned), namely moderate (M) and heavy (H), corresponding to 70 and 86 % VO2 peak, respectively. No change (P > 0.05) in VO2 peak was observed regardless of the training program. Based on the metabolic responses to prolonged exercise (60 % VO2 peak), both M and H and 30 and 60 min protocols displayed less of a decrease (P < 0.05) in phosphocreatine (PCr) and glycogen (Glyc) and less of an increase (P < 0.05) in free adenosine diphosphate (ADPf), free adenosine monophosphate (AMPf), inosine monophosphate (IMP) and lactate (La). Training for 60 min compared with 30 min resulted in a greater protection (P < 0.05) of ADPf, AMPf, PCr and Glyc during exercise, effects that were not displayed between M and H. The reduction in both VO2 and RER (P < 0.05) observed during submaximal exercise did not depend on training program specifics. These findings indicate that in conjunction with our earlier study (Green et al., Eur J Appl Physiol, 2012b), a threshold exists for duration rather than intensity of aerobic exercise to induce a greater training impact in reducing metabolic strain.

Adaptations in muscle metabolic regulation require only a small dose of aerobic-based exercise.

This study investigated the hypothesis that the duration of aerobic-based cycle exercise would affect the adaptations in substrate and metabolic regulation that occur in vastus lateralis in response to a short-term (10 day) training program. Healthy active but untrained males (n = 7) with a peak aerobic power ([Formula: see text]) of 44.4 ± 1.4 ml kg(-1) min(-1) participated in two different training programs with order randomly assigned (separated by ≥2 weeks). The training programs included exercising at a single intensity designated as light (L) corresponding to 60 % [Formula: see text], for either 30 or 60 min. In response to a standardized task (60 % [Formula: see text]), administered prior to and following each training program, L attenuated the decrease (P < 0.05) in phosphocreatine and the increase (P < 0.05) in free adenosine diphosphate and free adenosine monophosphate but not lactate. These effects were not altered by daily training duration. In the case of muscle glycogen, training for 60 versus 30 min exaggerated the increase (P < 0.05) that occurred, an effect that extended to both rest and exercise concentrations. No changes were observed in [Formula: see text] measured during progressive exercise to fatigue or in [Formula: see text] and RER during submaximal exercise with either training duration. These findings indicate that reductions in metabolic strain, as indicated by a more protected phosphorylation potential, and higher glycogen reserves, can be induced with a training stimulus of light intensity applied for as little as 30 min over 10 days. Our results also indicate that doubling the duration of daily exercise at L although inducing increased muscle glycogen reserves did not result in a greater metabolic adaptation.

Muscle cellular properties in the ice hockey player: a model for investigating overtraining?

In this study, we hypothesized that athletes involved in 5-6 months of sprint-type training would display higher levels of proteins and processes involved in muscle energy supply and utilization. Tissue was sampled from the vastus lateralis of 13 elite ice hockey players (peak oxygen consumption = 51.8 ± 1.3 mL·kg(-1)·min(-1); mean ± standard error) at the end of a season (POST) and compared with samples from 8 controls (peak oxygen consumption = 45.5 ± 1.4 mL·kg(-1)·min(-1)) (CON). Compared with CON, higher activities were observed in POST (p < 0.05) only for succinic dehydrogenase (3.32 ± 0.16 mol·(mg protein)(-1)·min(-1) vs. 4.10 ± 0.11 mol·(mg protein)(-1)·min(-1)) and hexokinase (0.73 ± 0.05 mol·(mg protein)(-1)·min(-1) vs. 0.90 ± 0.05mol·(mg protein)(-1)·min(-1)) but not for phosphorylase, phosphofructokinase, and creatine phosphokinase. No differences were found in Na(+),K(+)-ATPase concentration (ß(max): 262 ± 36 pmol·(g wet weight)(-1) vs. 275 ± 27 pmol·(g wet weight)(-1)) and the maximal activity of the sarcoplasmic reticulum Ca(2+)-ATPase (98.1 ± 6.1 µmol·(g protein)(-1)·min(-1) vs. 102 ± 3.3 µmol·(g protein)(-1)·min(-1)). Cross-sectional area was lower (p < 0.05) in POST but only for the type IIA fibres (6312 ± 684 µm(2) vs. 5512 ± 335 µm(2)), while the number of capillary counts per fibre and the capillary to fibre area ratio were generally higher (p < 0.05). These findings suggest that elite trained ice hockey players display elevations only in support of glucose-based aerobic metabolism that occur in the absence of alterations in excitation-contraction processes.

Malleability of human skeletal muscle sarcoplasmic reticulum to short-term training.

This study investigated the hypothesis that adaptations would occur in the sarcoplasmic reticulum in vastus lateralis soon after the onset of aerobic-based training consistent with reduced Ca²âº-cycling potential. Tissue samples were extracted prior to (0 days) and following 3 and 6 days of cycling performed for 2 h at 60%-65% of peak aerobic power (VO2(peak)) in untrained males (VO2(peak) = 47 ± 2.3 mL·kg⁻¹·min⁻¹; mean ± SE, n = 6) and assessed for changes (nmol·mg protein⁻¹·min⁻¹) in maximal Ca²âº-ATPase activity (V(max)), Ca²âº-uptake, and Ca²âº-release (phase 1 and phase 2) as well as the sarcoplasmic (endoplasmic) reticulum Ca²âº-ATPase (SERCA) isoforms. Training resulted in reductions (p < 0.05) in SERCA1a at 6 days (-14%) but not at 3 days. For SERCA2a, reductions (p < 0.05) were also noted only at 6 days (-7%). For V(max), depressions (p < 0.05) were found at 6 days (172 ± 11) but not at 3 days (176 ± 13; p < 0.10) compared with 0 days (192 ± 11). These changes were accompanied by a lower (p < 0.05) Ca²âº-uptake at both 3 days (-39%) and 6 days (-48%). A similar pattern was found for phase 1 Ca²âº-release with reductions (p < 0.05) of 37% observed at 6 days and 23% (p = 0.21) at 3 days of training, respectively. In a related study using the same training protocol and participant characteristics, microphotometric determinations of V(max) indicated reductions (p < 0.05) in type I at 3 days (-27%) and at 6 days (-34%) and in type IIA fibres at 6 days (-17%). It is concluded that in response to aerobic-based training, sarcoplasmic reticulum Ca²âº-cycling potential is reduced by adaptations that occur soon after training onset.

Association of peak aerobic power with capillary density but not oxidative potential in human vastus lateralis muscle.

In this study, we have postulated that in healthy males, peak aerobic power ([Formula: see text]) would associate with muscle capillary density rather than oxidative potential, regardless of fibre type or subtype. To test this, active but untrained volunteers (n = 11) were separated into high (HI) and low (LO) groups based on [Formula: see text] obtained during a progressive cycle task to fatigue. The 26% higher (P < 0.05) [Formula: see text] observed in HI (40.8 ± 1.5 mL·kg(-1)·min(-1), mean ± SE) compared with LO ( 51.4 ± 0.90 mL·kg(-1)·min(-1), mean ± SE) was not accompanied by differences in age (21.3 ± 1.2 compared with 21.1 ± 0.63 years, respectively) or body mass (72.4 ± 4.6 compared with 71.6 ± 1.9 kg, respectively). Tissue samples obtained from the vastus lateralis indicated greater (P < 0.05) capillary counts per fibre (CC; +24%) in HI compared with LO, regardless of fibre type (I, IIA, IIX, IIAX). Capillary density (CD) as measured in a field of defined area was also elevated (+22%; P < 0.05), as was the number of capillaries per fibre (+22%; P < 0.05). No differences were observed between the 2 groups in the distribution, area, and the CC/fibre area ratio in the different fibre types and subtypes. Similarly, there was no difference between the HI and LO groups in oxidative potential, as measured by succinic dehydrogenase activity in the different fibre types. It is concluded that the higher capillary density may contribute to improved vascular conductance and the elevated [Formula: see text] observed in the untrained participants.

Cellular responses in skeletal muscle to a season of ice hockey.

We hypothesized that a season of ice hockey would result in extensive remodeling of muscle. Tissue sampled from the vastus lateralis of 15 players (age = 20.6 ± 0.4 years; mean ± SE) prior to (PRE) and following (POST) a season was used to characterize specific adaptations. Measurement of representative metabolic pathway enzymes indicated higher maximal activities in POST than in PRE (p < 0.05) for succinic dehydrogenase (3.26 ± 0.31 vs. 3.91 ± 0.11 mol mg protein(-1) min(-1)), citrate synthase (7.26 ± 0.70 vs. 8.70 ± 0.55 mol mg protein(-1) min(-1)), and phosphofructokinase (12.8 ± 1.3 vs. 14.4 ± 0.96 mol mg protein(-1) min(-1)) only. The season resulted in an increase in Na+-K+-ATPase concentration (253 ± 6.3 vs. 265 ± 6.0 pmol g(-1) wet weight), a decrease (p < 0.05) in maximal activity of the sarcoplasmic reticulum Ca2+-ATPase (107 ± 4.2 micromol g protein(-1) min(-1) vs. 92.0 ± 4.6 micromol g protein(-1) min(-1)), and no change in the distribution (%) of fibre types. A smaller (p < 0.05) cross-sectional area (CSA) for both type I (-11.7%) and type IIA (-18.2%) fibres and a higher (p < 0.05) capillary count/CSA for type I (+17.9%) and type IIA (+17.2%) were also found over the season. No changes were found in peak oxygen consumption (51.4 ± 1.2 mL kg(-1) min(-1) vs. 52.3 ± 1.3 mL kg(-1) min(-1)). The results suggest, based on the alterations in oxidative and perfusion potentials and muscle mass, that the dominant adaptations are in support of oxidative metabolism, which occurs at the expense of fibre CSA and possibly force-generating potential.

Vastus lateralis Na(+)-K(+)-ATPase activity, protein, and isoform distribution in chronic obstructive pulmonary disease.

In this study we investigate the hypothesis that protein abundance, isoform distribution, and maximal catalytic activity of sodium-potassium-adenosine triphosphatase (Na(+)-K(+)-ATPase) would be altered in muscle of patients with moderate to severe chronic obstructive pulmonary disease (COPD). Tissue samples were obtained from the vastus lateralis of 10 patients with COPD (mean +/- SE: age = 67 +/- 2.9 years; FEV1 = 39 +/- 5.5%) and 10 healthy, matched controls (CON: age = 68 +/- 2 years; FEV1 = 114 +/- 4.2%). The samples were assessed for maximal catalytic activity (Vmax) of the enzyme using the K(+)-stimulated 3-O-methylfluorescein-phosphatase (3-O-MFPase) assay, enzyme abundance using the [3H]-ouabain assay, and isoform content of both alpha (alpha1, alpha2, alpha3) and beta (beta1, beta2, beta3) using Western blot techniques. A 19.4% lower (P < 0.05) Vmax was observed in COPD compared with CON (90.7 +/- 6.7 vs. 73.1 +/- 4.7 nmol x mg protein(-1) h(-1)). No differences between groups were observed for pump concentration (259 +/- 15 vs. 243 +/- 17 pmol x g wet weight). For the isoforms, alpha1 was decreased by 28% (P < 0.05), and alpha2 was increased by 12% (P < 0.05) in COPD compared with CON. No differences between groups were observed for alpha3 or for the beta isoforms. We conclude that moderate COPD compromises Vmax, which occurs in the absence of changes in pump abundance. The reduction in Vmax could be due to a shift in isoform expression (alpha1, alpha2), alterations in intrinsic regulation, or to structural changes in the enzyme. The changes observed in the catalytic activity of the pump could have major effects on membrane excitability and fatigability, which are typically compromised in COPD.

Screening and recording of alcohol use among women of child-bearing age and pregnant women.

A woman's alcohol use during pregnancy is one of the top preventable causes of birth defects and developmental disabilities that are known as fetal alcohol spectrum disorders (FASD). The social and economic burden of FASD is substantial. Lifetime direct tangible costs per individual related to health care, education and social services in Canada have been estimated to be $1.4 million. Screening women of child-bearing age and pregnant women and recording their alcohol consumption is a practical process to identify and evaluate women at-risk and to identify potentially exposed infants. The FASD Advisory Workgroup proposes the following three levels of screenings which should be done on consenting women: Level I screening involves practice-based approaches that can be used by health care providers when talking to women about alcohol use, such as motivational interviewing and supportive dialogue. Level II screening includes a number of structured questionnaires that can be used with direct questioning (TLFB) or indirect /masked screening (AUDIT, BMAST / SMAST, CAGE, CRAFFT, T-ACE, TWEAK). Level III screening includes laboratory-based tools that can be used to confirm the presence of a drug, its level of exposure and determine the presence of multiple drugs. There are challenges and limitations in the use of the screening and assessment tools outlined. For example, the single question about alcohol use and the various questionnaires rely on a woman to provide details about her alcohol use. There is no consensus on the appropriate screening to use across Canada as each provincial / territorial jurisdiction, health care organization and healthcare provider uses a variety of formal and informal screening tool. In addition, there are inconsistent processes across Canada for the recording of the alcohol use in a woman's chart and the transfer of the information to the infant and the child's health records. The FASD Advisory Workgroup proposes eleven recommendations to improve the screening and recording processes for alcohol use in women of child-bearing age and pregnant women.

Cellular assessment of muscle in COPD: case studies of two males.

The objective of this paper is to provide an overview of the recent developments in muscle physiology and biochemistry in general, and with respect to chronic obstructive pulmonary disease (COPD) specifically. As a way of illustration, we have presented data on the remodeling that occurs in vastus lateralis in two patients with COPD (COPD #1, forced expiratory volume in one second/forced vital capacity [FEV(1)/FVC] = 63%; COPD #2, FEV(1)/FVC = 41%) exhibiting differences in muscle wasting as compared to healthy controls (CON; FEV(1)/FVC = 111 +/- 2.2%, n = 4). Type I fibers percentages were lower in both COPD #1 (16.7) and COPD #2 (24.9) compared to CON (57.3 +/- 5.2). Cross sectional area of the type I fibers of the patients ranged between 65%-68% of CON and for the type II subtypes (IIA, IIAX, IIX) between 74% and 89% (COPD #1) and 17%-32% (COPD #2). A lower number of capillary contacts were observed for all fiber types in COPD #1 but not COPD #2. Lower concentrations of adenosine triphosphate (ATP) (24%-26%) and phosphocreatine (18%-20%), but not lactate occurred in COPD. In contrast to COPD #1, who displayed normal glucose transporter content, GLUT1 and GLUT4 were only 71% and 54%, respectively of CON in COPD #2. Lower monocarboxylate contents were found for MCT1 in both COPD #1 (63%) and COPD #2 (41%) and for MCT4 (78%) in COPD #1. Maximal oxidative enzyme activities (V(max)) for COPD #2 ranged between 37% (succinic dehydrogenase) and 70% (cytochrome C oxidase) of CON. For the cytosolic enzymes, V(max) ranged between 89% (hexokinase) to 31% (pyruvate kinase) of CON. Depressions were also observed in V(max) of the Na(+)-K(+)-ATPase for COPD #1 (66% of CON) but not COPD #2 (92% of CON) while V(max) of the Ca(2+)-ATPase was near normal in COPD #1 (84% CON). It is concluded that disturbances can occur in muscle to a wide range of excitation, contraction and metabolic processes in COPD.

Review of meningioma histopathology.

The histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. The relationship between histological features and prognosis is formalized in grading schemes such as those published by the World Health Organization (WHO), most recently in 2007. Although the latest edition is an improvement over previous grading schemes, the WHO scheme still fails to fully address a variety of important issues regarding the relationship between meningioma histological characteristics and behavior. In particular, routine histological examination fails to identify the subset of Grade I tumors that behave aggressively. Because of this, many additional prognostic markers that require immunohistochemical, cytogenetic, or molecular techniques to evaluate are under investigation. Only one, immunohistochemistry for the proliferation marker, Ki 67 (MIB-1), is used routinely and it has only limited utility. It is hoped that an understanding of the genetic changes that underlie tumor progression will improve healthcare professionals' ability to predict the behavior of meningiomas.

Training effects in mice after long-term voluntary exercise.

BACKGROUND: Mice are an important animal model in exercise studies on the immune system, cancer, and aging. There is limited research about the training effects of long-term voluntary exercise in this species. PURPOSE: To describe the training effects in mice given long-term aerobic voluntary exercise. METHODS: Female C57BL/6 mice were randomly assigned to 1) individual cages with in-cage running wheels with 24-h access (WR; N = 31), or 2) individual cages without running wheels for 16 wk (NR; N = 20). Run-to-exhaustion (RTE) times, VO2peak, speed at VO2peak, and citrate synthase (CS), succinate dehydrogenase (SDH), and phosphofructokinase (PFK) activity in the soleus, plantaris, and red and white gastrocnemius were assessed. RESULTS: Final body weight and speed at VO2peak did not differ by training condition. WR mice had significantly longer RTE times (P < 0.001) and higher VO2peak (P < 0.05) compared with NR mice. Higher CS and SDH activities were found in WR compared with NR mice for soleus (P < 0.01), red gastrocnemius (P < 0.01), and plantaris (P < 0.01) muscles. PFK activity was higher in WR mice in white gastrocnemius compared with NR mice (P < 0.01). CONCLUSIONS: Voluntary running wheel activity for 16 wk in female C57BL/6 mice resulted in longer run times to exhaustion, higher VO2peak, and higher SDH and CS activities in oxidative muscles. These findings suggest that wheel running in female C57BL/6 mice: 1) produces a measurable aerobic training effect and 2) is an effective exercise modality for long-term training studies.

Prevalence of primary dysmenorrhea in Canada.

OBJECTIVE: The aim of this study was to describe the prevalence, clinical effect, characteristics, and underlying risk factors of primary dysmenorrhea (PD) in Canada. METHODS: A stratified, random sample of 2721 women 18 years and older was identified, and the women were interviewed by telephone. Data about menstrual symptoms and patterns and socio-demographic factors were obtained. The frequency, severity, and effect of menstrual pain were quantified. Logistic regression analysis was performed in order to identify independent risk factors for PD. RESULTS: In the sample, 1546 women were having menstrual periods; of these, 934 (60%) met the criteria for PD. Sixty percent of the women with PD described their pain as moderate or severe. Fifty-one percent reported that their activities had been limited, and 17% reported missing school or work because of PD. The prevalence of PD decreased with increasing age (P < 0.001) and increased with smoking (P = 0.002). Users of oral contraceptives (OCs) tended to have less pain than non-users (P = 0.005). Socio-economic status, nulliparity, and earlier age at menarche were not independently associated with PD. However, nulliparous women, smokers, and women not using OCs were more likely to report disabling symptoms. CONCLUSIONS: The majority of Canadian women will suffer from dysmenorrhea at some time during their reproductive years. Available prescription treatments are underused. Young age, smoking, and non-use of OCs are independent risk factors for PD.

Primary dysmenorrhea consensus guideline.

METHODS: Members of this consensus group were selected based on individual expertise to represent a range of practical and academic experience both in terms of location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology backgrounds. The consensus group reviewed all available evidence through the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. RESULTS: This document provides a summary of up-to-date evidence regarding the diagnosis, investigations, and medical and surgical management of dysmenorrhea. The resulting recommendations may be adapted by individual health care workers when serving women who suffer from this condition. CONCLUSIONS: Dysmenorrhea is an extremely common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle, medications, and allied health services should be used to limit the impact of this condition on activities of daily living. In some circumstances, surgery is required to offer the desired relief. OUTCOMES: This guideline discusses the various options in managing dysmenorrhea. Patient information materials may be derived from these guidelines in order to educate women in terms of their options and possible risks and benefits of various treatment strategies. Women who find an acceptable management strategy for this condition may benefit from an improved quality of life.