Clostridium botulinum toxin A inhibits contractility in pregnant human myometrium in vitro.

Studies were undertaken to evaluate the effect of Botulinum neurotoxin type-A (BoNTA) preparation on oxytocin-induced contractions of pregnant human myometrium in vitro. Human myometrial tissue was exposed to increasing concentrations (1-50 000 U/mL) of BoNT/A. Isometric contractions were measured using a force displacement transducer. The cumulative effect of BoNT/A on myometrial activity (time to half relaxation [TTR50], frequency, and amplitude) was evaluated. The frequency of myometrial contractions was depressed by 40% from baseline (P < .05) and relaxation time was increased by 30% (P < .05) from baseline within a narrow range of concentrations. There was no significant difference in amplitude. The observed effects were rapidly reversed after complete wash out of the tissue. BoNT/A or its analogues with more specific tissue affinity may be of value as future agents for prevention of unwanted uterine contractile activity associated with preterm labor and fetal surgery.

Impact of physician gender on sexual history taking in a multispecialty practice.

INTRODUCTION: Identification of sexual dysfunction may help physicians diagnose problems such as diabetes, pituitary tumors, atherosclerosis, and depression. Sexual concerns are common among patients; however, there is evidence to suggest that these concerns are not appropriately investigated by clinicians. AIM: To examine the impact of physician gender on sexual history taking. METHODS: One hundred and thirty-one study questionnaires were sent to OB/Gyns, family practitioners, internists, pediatricians, and surgeons. Physicians were asked to rank their discomfort during interviews with patients of different ages, races, marital status, sexual preference, religious beliefs, and academic achievement, and they were asked to rank their perception of patient discomfort. MAIN OUTCOME MEASURES: A cross-sectional descriptive analysis was generated, Fisher's exact test was performed utilizing SPSS software, and confidence intervals were developed utilizing SAS software. RESULTS: Of the 78 questionnaires (59%) returned, 69 (88%) reported taking sexual histories. Characteristics identified by physicians as causing discomfort included patient's age younger than 18 and greater than 65, patient's academic achievement below college level, and patient's divorced or single marital status. Moreover, there was a statistically significant difference (P < 0.05) between male and female physicians reporting their discomfort when interviewing males (19% and 50%, respectively) and females (35% and 12%, respectively). CONCLUSION: Although a high percentage of practitioners report taking a sexual history, physicians reported and perceived greatest discomfort when interviewing opposite gender patients as well as patients of very young and old ages. It is clear that not only is there a need for physician education on the topic of sexual history taking, but also consideration of the impact of physician and patient gender.