Calcium and conjugated linoleic acid reduces pregnancy-induced hypertension and decreases intracellular calcium in lymphocytes.

BACKGROUND: The aim of the present study was to determine whether the beneficial effect of oral supplementation with calcium and conjugated linoleic acid (CLA) in the reduction of the incidence of pregnancy-induced hypertension (PIH) is related with changes in plasma levels of prostanoids, renin, angiotensin II, calciotropic hormones, and plasma and intracellular ionized free calcium. METHODS: These mediators were determined using the blood samples obtained from a randomized, double-blind, placebo-controlled trial that included 48 healthy primigravidas with a family history of preeclampsia and with diastolic notch, recruited from four outpatient clinics from two developing countries. Participants were randomized to daily oral doses of elemental calcium and CLA or lactose-starch placebo from week 18 to week 22 of gestation until delivery. RESULTS: The incidence of PIH was significantly reduced in women receiving the supplement (2 women [8.3%]) compared with placebo (10 women [41.7%]) (relative risk = 0.20, 95% confidence interval 0.05-0.82, P = .01). There were no significant differences in the plasma concentrations of ionized calcium, prostaglandin E(2), renin, angiotensin II, parathormone,and calcitonine. The concentration of intracellular ionized free calcium presented a significant reduction after interventions (92.0 nmol/L [range 62.5 to 220 nmol/L] v 62.5 nmol/L [range 28 to 200 nmol/L; P = .01) in the supplemented group but not in the placebo group. The women who developed PIH (n = 12) presented a significant increase in the concentrations of intracellular calcium after interventions (120 nmol/L [range 89.2 to 240 nmol/L] v 137.5 nmol/L [range 89.2 to 138 nmol/L; P = .02). CONCLUSIONS: Calcium and CLA supplementation during pregnancy reduces the incidence of PIH, and decreases the intracellular concentration of ionized free calcium in peripheral blood lymphocytes.

A randomized comparative study on mifepristone alone and in combination with tamoxifen for emergency contraception.

The purpose of the clinical study was to compare the efficacy and side effects of 10 mg of mifepristone alone (Group 1) and with 20 mg of tamoxifen (Group 2) for emergency contraception, especially as used within 72-120 h after coitus. Four-hundred female volunteers with one act of unprotected intercourse or contraception failure (200 cases in each group) were recruited and completed the study. There were 198 women treated < 72 h after coitus (100 in Group 1 and 98 in Group 2), whereas the remaining 202 patients were treated between 72-120 h (100 in Group 1 and 102 in Group 2). In total, four pregnancies occurred; one treated < 72 h in each group, two between 72-120 h in Group 1. Efficacy for prevention of unwanted pregnancy by Trussell method is 84% for Group 1, and 95% for Group 2, and which is not significantly different between the two groups and even subgroups. The side effects (15.5% for Group 1 and 14.5% for Group 2) and changes in menstruation were infrequent and mild in both groups. Further studies should be conducted to determine whether tamoxifen combined with mifepristone for emergency contraception is more effective as compared with mifepristone alone.

Reference value of semen quality in Chinese young men.

The purpose of the study was to evaluate semen quality in young Chinese men and to establish reference values. Normal healthy young men from seven geographical areas were enrolled. The study showed that the mean sperm volume was 2.61 mL, and mean percent of sperm with forward progression was 59.89, while median of semen viability was 79.0%, and geometric mean of semen density was 55.45 x 10(6)/mL. Proportion of routine semen indexes that met World Health Organization (WHO) criteria were as follows: 81.9% for semen volume, 91.1% for liquefaction time, 93.4% for viscosity, 90.8% for pH, 81.3% for sperm with forward progression, 65.3% for sperm viability, 93.8% for semen density, 98.8% for normal sperm morphology, and 89.1% for total sperm count. Participants whose sperm met all WHO standard parameters accounted for 42.3%. Because the infertility rate in China is about 10-15%, the fifteenth percentile of semen parameters might be used as the lower limit of reference values, which may be more appropriate for young Chinese men. The fifteenth percentiles of parameters in this study were as follows: 1.5 mL for semen volume, 7.2 for pH value, 45% for proportion of sperm with forward progression, 68% for sperm viability, 30 x 10(6)/mL for semen density, 68% for proportion of sperm with normal morphology, and 50 x 10(6) for total sperm count.

Levels of change in adolescent sexual behavior in three Asian cities.

Considerable change in the romantic and sexual behaviors of Asian young people may be occurring as traditionally Confucian societies modernize and increase outside contacts. This study explores the dimensions and context of this change in three sites at different stages in the process of modernization: Hanoi (early), Shanghai (intermediate), and Taipei (later stage). A survey was conducted of 17,016 males and females aged 15-24 in urban and rural settings in three large metropolitan areas. Survival analysis and Cox regressions were performed to explore ages of respondents at key transitions and the significance of differences between two age cohorts: 15-19 and 20-24. Significant differences are found in levels of sexual and other transitions, even within the narrow time span reflected by the age cohorts. The findings highlight the differential impact of modernization on adolescent sexual behavior as traditional societies undergo social change, and they underline the importance of context in exploring youthful transitions.

Are serum zinc and copper levels related to semen quality?

Low serum zinc levels are harmful to semen quality in Chinese men. In this study, eligible men aged 20-59 years old-excluding those who had ever had urinary or genital disease, tuberculosis, or occupational heavy metal contact-were examined for semen quality and serum zinc and copper concentrations. Progressive motility showed differences among the five copper groups, but multiple logistic analyses did not show that higher or lower serum copper levels had a significant effect on sperm quality. When serum zinc concentration was low, the risk of asthenozoospermia was higher. The ratio of Cu/Zn was higher in the progressive motility abnormal group than in the normal group.

Evaluación periódica del riesgo biopsicosocial prenatal en la predicción de las complicaciones maternas y perinatales en Asia 2002-2003 / Periodical assessment of the prenatal biopsychosocial risk to predict obstetric and perinatal complications in Asian countries 2002-2003

Objetivo: Describir el nivel de predicción de las complicaciones obstétricas y perinatales mediante la evaluación periódica del riesgo biopsicosocial prenatal (RBP) durante el control prenatal en mujeres asiáticas. Materiales y métodos: Durante el 2002 se evaluaron en Shanghai, China y Dhaka, Bangalesh 565 primigrávidas sanas con evaluaciones periódicas del RBP (primera: semana 14-27, segunda: semana 28-32, tercera: semana 33-42) con evaluación prospectiva del resultado materno y perinatal. Resultados: La edad promedio fue 25.1±6.4 años en su mayoría de nivel socioeconómico medio, con formación universitaria y residencia urbana. Se observaron 135 (23.9%) complicaciones obstétricas, 57 (10.1%) recién nacidos con bajo peso y 41 (7.3%) muertes perinatales. El alto riesgo biopsicosocial prenatal se asoció con las complicaciones obstétricas (área bajo la curva ROC) 0.80 IC 95% 0.71-0.89 con el parto prematuro (área bajo la curva ROC) 0.79, IC 95% 0.68-0.90) y con el bajo peso al nacer (área bajo la curva ROC) 0.85, IC 95% 0.77-0.93. El período con mayor efectividad predictiva fue el último (33-42 semanas) tanto para las complicaciones obstétricas (sensibilidad: 84.4%, especificidad: 69.3%), como para el parto prematuro (sensibilidad: 79.2%, especificidad: 67.1%) como para el bajo peso al nacer (sensibilidad: 88% especificidad: 77.3%). A pesar de las diferencias basales sociodemográficas, nutricionales, étnicas, culturales y religiosas de los dos países el efecto predictivo del instrumento fue similar. Conclusión: La evaluación del riesgo biopsicosocial prenatal fue clínicamente válida para predecir complicaciones obstétricas, parto prematuro y bajo peso al nacer en los países asiáticos comparable a los resultados en Latino-América.

Objective: To determine the effect of the periodical use of the prenatal biopsychosocial risk assessment (PBR) to predict obstetric and perinatal complications in pregnant women in Asian countries. Materials and methods: In Shanghai, China, and Dhaka, Bangladesh, 565 healthy primigravids were evaluated with PBR at inclusion (14-27 weeks), in a second time (28-32 weeks) and in a third time (33-42 weeks) with assessment of the perinatal outcome. Results: The average age was 25.1±6.4 years old. Most of the women were from middle socioeconomic level, with university academic degree and urban residence. There were 129 (25.6%) obstetric complications, 54 (10.1%) low birth weight babies and 41 (7.3%) perinatal deaths. The ROC analysis showed that the high PBR score was associated with obstetric complications (area under ROC Curves) 0.80 CI 95% 0.71-0.89, preterm birth (area under ROC curves) 0.79, CI 95% 0.68-0.90, low birth weight (area under ROC curves) 0.85, CI 95% 0.77-0.93. The best predictive period was the last (33-42 weeks) to obstetric complications (sensibility: 84.4%, specificity: 69.3%), preterm delivery (sensibility 79.2%, specificity 67.1%) and to low birth weight (sensibility 88%, specificity 77.3%). The baseline sociodemographic and nutritional characteristics and the perinatal outcome were different between the countries, however, the predictive effect of the instrument was similar. Conclusion: The prenatal biopsychosocial risk assessment was clinically valid to predict obstetric complications, preterm birth and low birth weight in two Asian countries when compared to results in Latin-American countries.

Efectos de la suplementacion oral con calcio y ácido linoleico conjugado en primigrávidas de alto riesgo / Effects of calcium and linoleic acid conjugated diet in pregnancy of high risk

Objetivo: Determinar el efecto de dosis bajas de calcio elemental y ácido linoleico conjugado sobre los niveles plasmáticos de tromboxano B2, insulina, aldosterona, GMP cíclico, proteína C reactiva ultrasensible y la eficacia del tratamiento en la prevención de la hipertensión arterial inducida por el embarazo. Métodos: En un ensayo clínico doble ciego, controlado con placebo se estudiaron a 48 primigrávidas con alto riesgo para desarrollar preeclampsia con dosis diarias de calcio elemental (600 mg) y ácido linoleico conjugado (450 mg) (n=24) ó 450 mg de talco y 600 mg de lactosa como placebo (n=24) desde la semana 18-22 hasta el parto. Resultados: Dos mujeres en el grupo experimental (8.3/100) desarrollaron hipertensión arterial inducida por el embarazo comparado con 10 (41.7/100) mujeres controles (riesgo relativo 0.20, IC 95/100 0.05-0.82, p=0.01). No se observaron diferencias entre los niveles plasmáticos después de 4 semanas de tratamiento ni efectos maternos o neonatales en ambos grupos. Conclusiones: La administración de dosis bajas de calcio elemental y ácido linoleico conjugado redujo significativamente la incidencia de hipertensión arterial inducida por el embarazo en mujeres embarazadas de alto riesgo sin efectos colaterales atribuibles a la intervención y sin efecto sobre los niveles de tromboxano B2, insulina, aldosterona, GMP cíclico y la respuesta sistémica inflamatoria