Jewish denominations and longevity.

This study examined the relationship between affiliation with one of three denominations within Judaism representing a conservative-liberal continuum of Orthodox, Conservative, and Reform Judaism. The criterion for affiliation was burial in a cemetery maintained by these denominations. Longevities of married congregants born 1850-1910 were compared, controlling for birth year. Orthodox Jews had the shortest life spans (77 years); Conservative and Reform Jews had very similar life spans (80.7 years). Differences in years of survival of husbands after death of a spouse did not differ significantly. Reform widows survived longest (16.5 years) after death of a spouse. Conservative and Reform widows did not differ significantly from one another.

Hysterectomy subsequent to endometrial ablation.

STUDY OBJECTIVE: To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Gynecology practice. PATIENTS: Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months. INTERVENTIONS: Endometrial ablation and hysterectomy. MEASUREMENTS AND MAIN RESULTS: Of 1169 women, 157 (13.4%) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95% CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1%; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0% for rollerball vs 16.5% for thermal balloon (p = .003), 11.0% for radiofrequency (p < .001), and 9.8% for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4% of hysterectomy specimens. CONCLUSION: With a mean follow-up of 39 months, 13.4% of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.

Adverse obstetric outcomes associated with sonographically identified large uterine fibroids.

STUDY OBJECTIVE: To determine the impact of sonographically identified large uterine fibroids (>5 cm in diameter) on obstetric outcomes. DESIGN: Retrospective cohort study. SETTING: University teaching hospital. PATIENT(S): Women with singleton gestations (n = 95) noted to have uterine fibroids on obstetric ultrasonography from September 2009 through April 2010 and age-matched controls (n = 95). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Obstetric outcomes including short cervix, preterm premature rupture of membranes, and preterm delivery. RESULT(S): Compared to women with no fibroids or small fibroids (≤5 cm), women with large fibroids (>5 cm) delivered at a significantly earlier gestational age (38.6 vs. 38.4 vs. 36.5 weeks). Short cervix, preterm premature rupture of membranes, and preterm delivery were also significantly more frequent in the large fibroid group, and were associated with number of fibroids >5 cm in diameter. Blood loss at delivery was significantly higher in the large fibroid group (486.8 vs. 535.6 vs. 645.1 mL), as was need for postpartum blood transfusion (1.1 vs. 0.0 vs. 12.2%). CONCLUSION(S): Women with large uterine fibroids in pregnancy are at significantly increased risk for delivery at an earlier gestational age compared to women with small or no fibroids, as well as obstetric complications including excess blood loss and increased frequency of postpartum blood transfusion.

Maternal and paternal age and twinning in the United States, 2004-2008.

AIMS: To determine the effects of increasing maternal age and related maternal and possibly paternal factors. METHODS: A US database of more than 8 million births was analyzed to determine the relationships between maternal age, maternal ethnicity, marital status, maternal smoking and paternal age on twinning rates. RESULTS: Twinning rates increased proportionally with maternal age. African American women had a higher twinning rate than Caucasian women. Hispanic, Asian and Native American women had comparatively lower rates than Caucasians. After controlling for ethnicity and other maternal factors, increasing maternal age was still related to increased twinning rates. Increased paternal age had a small but significant independent association with an increased rate of twinning. CONCLUSIONS: Both increasing maternal and paternal age are related to increased rates of twinning. This age effect is independent of other factors also associated with twinning.

Facial resemblances between heterosexual, gay, and lesbian couples.

Researchers have noted a physical resemblance (homophily) between human sex partners. To date, these studies and their related interpretations have been based on heterosexual couples. The present study compared physical resemblances between gay, lesbian, and heterosexual couples, using 40 photographs of each from national newspapers, which were rated by 34 men and 56 women (M age = 53 yr., SD = 12.1). Half the photographs were of actual couples and half were randomly mixed within each group. Actual couples were rated as significantly more similar in appearance than random pairings of people. Ratings of similarity were significantly higher (indicating greater perceived homophily) for gay couples than heterosexual couples, while there was no statistically significant difference in similarity ratings between lesbian couples versus gay and heterosexual couples. The results were interpreted in terms of evolutionary and parental imprinting hypotheses.

Escitalopram treatment of menopausal hot flashes.

OBJECTIVE: The aim of this study was to determine the effects of 10 and 20 mg/day of escitalopram on objectively recorded hot flashes and on the rectal temperature threshold for sweating. METHODS: Two studies were performed: 16 women received 10 mg/day and 26 women received 20 mg/day escitalopram for 8 weeks. They were randomly assigned in equal numbers to receive active drug or placebo in a double-blind fashion. Hot flash frequency was measured with an ambulatory recorder during the first 3 weeks and during the 8th week of the study. Rectal temperature threshold for sweating was measured during the 1st and 8th weeks of the study using published methods. RESULTS: In the first study, there were no significant effects whatsoever for any measure. In the second study, the escitalopram group showed an average decline in hot flash frequency of 14.4%, whereas the placebo group showed an average increase of 6.7% (P < 0.05). However, there were no significant effects across time for either group. There were no significant effects whatsoever for rectal temperature sweating thresholds. CONCLUSIONS: Escitalopram at 10 or 20 mg/day is not effective in the treatment of menopausal hot flashes.

Heart rate variability in menopausal hot flashes during sleep.

OBJECTIVE: The aim of this study was to determine if heart rate variability changes during hot flashes recorded during sleep. METHODS: This study was performed in a university medical center laboratory with 16 postmenopausal women demonstrating at least four hot flashes per night. Polysomnography, heart rate, and sternal skin conductance to indicate hot flashes were recorded in controlled, laboratory conditions. RESULTS: For the frequency bin of 0 to 0.15 Hz, spectral power was greater during waking compared with non-rapid eye movement sleep and less during stages 3 and 4 compared with stages 1 and 2. Power was greater during hot flashes compared with subsequent periods for all hot flashes. Power was greater during hot flashes compared with preceding and subsequent periods for those recorded during stage 1 sleep. For waking hot flashes, power in this band was higher before hot flashes than during or after them. CONCLUSIONS: These data are consistent with our theory of elevated sympathetic activation as a trigger for menopausal hot flashes and with previous work on heart rate variability during the stages of sleep.

Endometrial morphology and modulation of hormone receptors during ovarian stimulation for assisted reproductive technology cycles.

OBJECTIVE: To study the biochemical and morphologic implications of different hormonal levels on endometrial development during assisted reproductive technology (ART) cycles. DESIGN: Prospective, controlled study. SETTING: University center. PATIENT(S): Eleven women during a natural cycle (controls) and 11 oocyte donors during an ART cycle (treated). INTERVENTION(S): At the time consistent with day-3 ET, a transvaginal ultrasound, an endometrial biopsy, and blood sampling were performed. Morphology and thickness of the endometrial stripe were recorded. Real-time reverse transcriptase-polymerase chain reaction was used to measure messenger RNA (mRNA) levels for estrogen receptor (ER)-α, ER-ß, P receptor (PR)-A, and PR-B in the endometrial tissue. MAIN OUTCOME MEASURE(S): To evaluate morphologic and biochemical endometrial development. RESULT(S): Endometrium was mostly trilaminar (proliferative-like pattern) and thicker in the treated group, as opposed to homogeneous and thinner in the controls. The PR-B mRNA expression increased 41% in treated patients; PR-A mRNA expression, instead, was unchanged. Serum E(2) and P were higher in the treated group than in controls. In contrast, FSH and LH levels were lower in the treated group. CONCLUSION(S): When compared with natural cycles, exposure of the endometrium to high hormone levels during ovarian stimulation significantly increased PR-B receptor expression at the time of ET. Concurrently, a proliferative-like endometrial pattern persisted. These findings reflect a delayed endometrial development in ART.

Athletes, doctors, and lawyers with first names beginning with "D" die sooner.

For many people, names have symbolic power that extends to their timing of death. This study examined the relationship between the symbolic significance of the first letters in the names of professional athletes (baseball, football, hockey, and basketball) and their longevity. A similar analysis was performed for doctors (radiologists, dermatologists, obstetricians/gynecologists) and lawyers for comparison purposes. There was a progressive decrease in longevity associated with names beginning with A to D when all athletes were combined. In each sport, athletes whose first names began with the letter D lived fewer years than those whose names collectively began with E to Z. Doctors and lawyers whose first names began with D also died earlier than those whose names began with E to Z but differences were not statistically significant. A Cox-regression survival analysis for athletes comparing those with names beginning with A, B, C and D vs. E to Z indicated that only those whose names began with D (median survival = 68.1 years) differed significantly from those with E to Z names (median survival = 69.9 years).

Birth month affects longevity.

The authors examined the association between birth month and longevity for major league baseball players. Players born in the month of November had the greatest longevities whereas those born in June had the shortest life spans. These differences remained after controlling for covariates such as birth year, career length, age at debut, height, and player position. The authors determined that the most likely explanation is that those born during seasons when mortalities are highest are constitutionally weakened and more likely to succumb to life threatening conditions later in life.

The widowhood effect: a comparison of Jews and Catholics.

Using mortality data derived from tombstones in two Midwestern cemeteries, we compared the "widowhood effect" (decreased survival following the death of a spouse) among Jews and Catholics. Jewish men and women were both more likely to die sooner after the death of their spouses compared to Catholic men and women. Life table survival analysis indicated that the median number of years of survival following widowhood for Catholic and Jewish men were 7.7 years and 5.0 years, respectively (p < .01). For Catholic and Jewish women, it was 11.0 and 9.5 years, respectively (p < .01). Interpretations were offered in terms of Bowlby's attachment theory.

Mortality salience of birthdays on day of death in the Major Leagues.

The authors assessed the relationship of mortality salience, as represented by birthdays, on the day of death. Preliminary studies considered the role of possible artifacts such as seasonality of birth and death, and time units for evaluation. On the basis of terror management theory's concept of "mortality salience," the authors hypothesized that famous people, in this case Major League Baseball (MLB) players, would be more likely to die on or after their birthdays than would be expected by chance (the "birthday blues"), and that the greater their fame, as represented by induction into the Baseball Hall of Fame, the greater the concentration of deaths shortly after birthdays. The results supported the hypothesis. Theoretical underpinnings of these results and practical implications were discussed.

Endometrial thickness dynamics and morphologic characteristics during pituitary downregulation with antagonists in assisted reproductive technology cycles.

OBJECTIVE: The purpose of this study was to evaluate whether the dynamics of endometrial stripe thickness during gonadotropin-releasing hormone (GnRH) antagonist pituitary downregulation in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles are related to implantation and pregnancy outcomes. METHODS: This retrospective cohort study evaluated 115 conventional IVF/ICSI cycles. All patients underwent ovarian stimulation with gonadotropins and the GnRH antagonist ganirelix acetate. The endometrial stripe was measured transvaginally daily from the day of initial GnRH antagonist administration to the day of the human chorionic gonadotropin (hCG) trigger and then transabdominally on the day of embryo transfer. We created 5 categories (0-4) of endometrial thickness variation, considering significant a daily variation of 1.5 mm. Our aim was to predict whether the endometrial thickness dynamics or morphologic characteristics were related to the duration of ovarian stimulation, duration of ganirelix use, or estradiol levels during ovarian stimulation and whether they would influence implantation and pregnancy rates. RESULTS: No relationship was found between the duration of ovarian stimulation, duration of ganirelix use, and estradiol level (expressed as the area under the curve), and endometrial thickness dynamics or morphologic characteristics. Despite a thinner endometrial thickness in 37% of the cycles on the day of the hCG trigger compared with the beginning of GnRH antagonist stimulation, there was no correlation between endometrial dynamics and pregnancy outcomes. There was, instead, a positive relationship between a trilaminar endometrial morphologic pattern with a positive pregnancy test result, successful implantation, and ongoing pregnancy (P < .05). CONCLUSIONS: Despite a net decrease in thickness in almost 50% of cases, endometrial dynamics did not correlate with pregnancy outcomes. Conversely, a trilaminar endometrial morphologic pattern on the day of embryo transfer was positively related to pregnancy outcomes.

The effect of estradiol on the expression of estrogen, progesterone, androgen, and prolactin receptors in human peritoneal fibroblasts.

PURPOSE: To assess the ability of fibroblasts isolated from normal peritoneum and adhesion tissues to express various hormone receptors when cultured with exogenous estradiol. METHODS: Primary cultures of fibroblasts from normal human peritoneum and adhesion tissue were treated with zero (control), 10(-10), 10(-8), and 10(-6) M concentrations of 17beta-estradiol. We performed real time reverse transcriptase polymerase chain reaction to determine mRNA levels of estradiol-alpha receptor (ER-alpha) and estradiol-beta receptor (ER-beta), progesterone receptor (P-R), androgen receptor (A-R), and prolactin receptor (PRL-R) in the two types of fibroblast cultures. RESULTS: In the control groups, P-R and A-R were higher in normal than in adhesion fibroblasts. In adhesion cells, ER-alpha were higher at 10(-8) estradiol; ER-beta were higher at 10(-6) M estradiol; P-R remained constant; A-R showed a higher expression at 10(-10) and 10(-8) M estradiol; and PRL-R showed an exponential increase at 10(-10) M estradiol. CONCLUSIONS: The inflammatory-like changes manifested by adhesion fibroblasts enhance the anabolic hormones receptor expression (ER-alpha, ER-beta, PRL, and A-R), when exposed to estradiol.

Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes.

PURPOSE: To evaluate whether oocyte quality, implantation and pregnancy outcomes in in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) are related to the duration of gonadotropin-releasing hormone (GnRH)-antagonist use or the timing of its initiation. METHODS: Retrospective cohort study of 178 conventional IVF/ICSI cycles. All patients underwent ovarian stimulation with gonadotropins and GnRH-antagonist for pituitary down-regulation. Spearman correlations and logistic regression were used for statistical analysis. RESULTS: There was no correlation between the duration of use or the timing of initiation of GnRH-antagonist with oocyte quality or implantation and pregnancy outcomes. Oocyte quality was influenced by the peak estradiol. Implantation was influenced by the patient's age. Early pregnancy loss, by the endometrial thickness on human chorionic gonadotropin-day. Ongoing pregnancy was independent from the variables evaluated. CONCLUSIONS: GnRH-antagonist duration of use or starting day did not influence oocyte quality, implantation rates, and pregnancy rates. We hypothesize that a follicle stimulating hormone/luteinizing hormone dose increase when antagonist was started, may have had an impact on our findings.

Age heterogamy and longevity: evidence from Jewish and Christian cemeteries.

In most marriages, husbands are older than wives at the time of marriage. The extent of this age difference is referred to as age heterogamy. Studies of age heterogamous marriages have found men and women married to younger spouses live longer than those married to spouses that are the same age at time of marriage. In this study we examined the role of a religious affiliation as a factor in this age heterogamy effect, by comparing Jewish and Christian husbands and wives. While we confirmed the age heterogamy effect on longevity, we did not find any evidence that it was affected by religion.

Endometrial thickness is related to miscarriage rate, but not to the estradiol concentration, in cycles down-regulated with gonadotropin-releasing hormone antagonist.

In this retrospective cohort study of 102 ovarian stimulation cycles for IVF/intracytoplasmic sperm injection using GnRH antagonist and gonadotropins, we sought to assess the effect of high E(2) levels on endometrial stripe thickness and its association with pregnancy outcomes and serum E(2) levels. We found no significant correlation between serum E(2) levels (both peak and area under the curve E(2) concentration) and the endometrial thickness. However, there was a statistically significant inverse relationship with early pregnancy loss (31%) if the endometrial thickness was <9.8 mm (sensitivity 71%; specificity 76%).

Precocity predicts shorter life for major league baseball players: confirmation of McCann's precocity-longevity hypothesis.

We tested McCann's precocity-longevity hypothesis, which proposes that early career achievement is related to premature death, for Major League baseball players (N = 3,760). Age at debut was the definition for precocity. We controlled for possible artifacts of life expectancy selection, the "healthy worker" effect, player position, and body-mass index. Statistically significant Pearson correlations occurred between precocity and longevity, and remained significant when adjusted for artifacts. In a hierarchical multiple regression, every year a baseball player debuted before the average age of 23.6 years was associated with life span being shortened by 0.24 years. The results support the hypothesis that earlier achievement is associated with earlier death.

Lefties are still a little shorter.

Heights and weights of right- and left-handed major league baseball pitchers (N=5780) were analyzed, adjusted for birth year. Right-handed pitchers were about 1.6 cm taller and 1.9 kg heavier than left-handed pitchers. The results corroborated other studies and suggest body size is related to handedness, although the average difference in height between right- and left-handed pitchers was very small.