Peptide YY(3-36)-induced inhibition of food intake in female monkeys.

Peptide YY (PYY) is produced in L cells of the intestine and is released after eating. PYY circulates in a truncated form designated PYY(3-36). PYY(3-36) is thought to be a physiologic anorexigenic peptide. The objective of the current study was to test the effect of exogenous PYY(3-36) on food intake in non-human primates exposed to different ovarian steroid milieus. The study was conducted in four ovariectomized cynomolgus monkeys replaced with estrogen alone for 2 weeks followed by estrogen in combination with progesterone for 2 weeks to mimic the menstrual cycle. The effect of PYY(3-36) on food intake was tested during each week of the simulated menstrual cycle by comparing the 2 h food intake following intracerebroventricular (icv) injection of artificial cerebrospinal fluid (aCSF) or PYY(3-36). Despite considerable variation in food intake following aCSF, PYY(3-36) consistently inhibited food consumption, except during week 2 of estrogen plus progesterone replacement. PYY(3-36) reduced food consumption by 16.2 g (95% confidence interval (CI)=4.5-27.9 g) and 26.6 g (95% CI=7.3-45.9 g) in weeks 1 and 2 respectively of estrogen only treatment and by 38.2 g (95% CI=26.1-50.2 g) in week 1 of estrogen plus progesterone treatment. In contrast, PYY(3-36) injected in week 2 of estrogen plus progesterone did not consistently inhibit food intake (13.1 g; CI=-49.5-75.7). This is the first study to report the effect of PYY(3-36) on food consumption in female monkeys. We conclude that icv administration of PYY(3-36) has a strong anorexic effect in female cynomolgus monkeys and that sensitivity to PYY(3-36) may be influenced by the ovarian steroid milieu.

What women believe about oral contraceptives and the effect of counseling.

OBJECTIVES: To evaluate Canadian women' s knowledge of the risks, benefits and side effects of oral contraceptives (OCs) and the effect of counseling. STUDY DESIGN: Six-hundred and forty-nine Canadian women filling an OC prescription at Shopper's Drug Mart stores completed the survey. Respondents recorded whether or not they had discussed 12 separate issues about OC use with their healthcare provider. Optimal responses to multiple-choice questions were compared between those reporting counseling to those reporting no counseling, using Fisher's Exact Tests. Women were also questioned on what they were told about associated cancer risks. RESULTS: Eighty percent or more of the women selected the optimal response for the questions relating to dysmenorrhea, leg pain and co-medication. Less than half of survey respondents identified the optimal response for nausea, breakthrough bleeding, breast tenderness, acne, headaches and weight change. Counseling made a significant impact on selection of the optimal response for 7 of the 12 questions (p < 0.004, adjusted significance level). Fifty-two percent indicated that they did not know what they were told about the risk of uterine and ovarian cancer when on the pill. A significant proportion of women said they would phone their physician for relatively minor problems such as breakthrough bleeding (65%), breast tenderness (55%) and acne (54%). CONCLUSIONS: The knowledge level of Canadian women on the pill regarding risks, benefits and side effects of the pill remains deficient in several key areas. Adequate counseling by healthcare providers can help women recognize the pill's positive health benefits, and may result in fewer unnecessary physician contacts and unwanted pregnancies.

A survey of recommendations by gynecologists in Canada regarding oral contraceptive use in the perioperative period.

OBJECTIVE: This survey was conducted to determine the practice patterns of gynecologists in Canada regarding the discontinuation of oral contraceptives before gynecologic surgical procedures. STUDY DESIGN: In May and June of 1997, surveys were sent to all obstetricians and gynecologists on the mailing list of the Society of Obstetricians and Gynaecologists of Canada. RESULTS: Of the 1472 surveys that were sent, 702 of the surveys were completed and returned, for a response rate of 48%. More than 90% of the gynecologists who were surveyed would advise their patients to continue using oral contraceptives before relatively minor surgical procedures and <1% of them would use low-dose heparin before these procedures. Rates of oral contraceptive discontinuation increased as the extent of the surgical intervention increased: Prolonged laparoscopy (39.8%), vaginal repairs and hysterectomy (54.7%), and abdominal hysterectomy or adnexectomy (56.1%). Just over one half of the gynecologists (56.1%) indicated that they would advise discontinuation > or =4 weeks before the surgical procedure, which is the minimum time required for the prothrombotic changes that are associated with oral contraceptive use to return to baseline. Less than 10% of the surgeons indicated that they would use low-dose heparin even when the patient was advised to continue taking oral contraceptives before major surgical procedures. CONCLUSION: The controversy over whether young healthy women should discontinue oral contraceptive use before major surgical procedures that are associated with immobility is reflected by a lack of consensus among gynecologists in Canada.