Presentation and management of POF: Findings from the West London POF database
Objective: In reports, abnormal macrophage migration inhibitory factor (MIF) production has been associated with several diseases. Furthermore, despite scarce data, increasing evidence suggest that MIF plays a central role in glucose homeostasis and in the development of type 1 and type 2 diabetes. However, serum MIF levels in Gestational diabetes mellitus (GDM) have not yet been investigated. To address this question we performed a prospective study between a group of pregnant women with GDM and healthy pregnant controls.
Materials and Methods: GDM group consisted of 43 pregnant women whereas the control group consisted of 40 healthy pregnant women. In the morning after an overnight fast, venous blood was sampled for the measurement of serum concentrations of insulin and MIF. Serum was separated by centrifugation and immediately stored at −80°C until the assay.
Results: There was no significant difference between the groups for maternal characteristics. Women with GDM had significantly higher levels of serum insulin (14.37±9.92 µU/ml vs. 8.78±4.35 µU/ml; P=.001) and serum MIF concentrations (11.31±4.92 ng/ml vs. 5.31±4.07 ng/ml; P<.001) when compared with healthy pregnant control group.
Conclusion: Our data demonstrated that serum levels of MIF are significantly elevated in patients with GDM. Our findings indicate that MIF might have a role in GDM; however, there is a need for further investigation.
Calcitonin Gene-Related Peptide (CGRP) seems to be involved in hot flushes in women and in castrated men. Therefore, we studied whether the plasma concentrations of CGRP changed during flushes in a group of healthy aging men. Twelve men (49-71 years), with no history of current or former prostate cancer or hormonal treatment, reporting ≥20 flushes/week were investigated. Blood samples were drawn during and between flushes for analysis of CGRP and also androgen concentrations, i.e. Testosterone and Bioavailable Testosterone were analysed. Skin temperature and skin conductance were monitored.
35 flushes were reported by 10 men. The plasma concentrations of CGRP did not increase during flushes. No significant change in skin temperature or conductance was found.
CGRP is probably not involved in the mechanisms of flushes in healthy aging men.
Therefore, flushes in aging healthy men seem to be different from flushes in men and women deprived of sex-steroids where CGRP increases during flushes.
Objective: to verify the efficacy of the double action mechanism of venlafaxine for depression and climacteric symptoms.
Methods: a group of twenty postmenopausal women (age range 40-60 years) with diagnosis of Major Depressive Disorder, Generalized Anxiety Disorder and climacteric symptoms was enrolled. All participants received vennlafaxine (75 mg/day) for two months. Clinical check-up and evaluation test were repeated every two weeks for two months of treatment.
Results: before treatment the mean scores for the clinical evaluation scales (Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale) were 13.9 and 18.7 respectively (mild-moderate severity). The general level of psychopathology was not particularly high (Symptomatology Check list-90 mean total 103), the most common psychopathological dimension were depression and somatisation. The sample suffered from mild climacteric syndrome (Kupperman Index Score mean=19.1).
Clinical improvement was visible after two weeks of treatment and continued until the last check-up, two months after the start of treatment (final Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores: 5.1 and 6.3 respectively). Kupperman Index Scores at the end of the treatment period demonstrated complete resolution of the climacteric syndrome (mean score=6.57).
Conclusion: venlafaxine is efficacy in treating both psychiatric disorders and climacteric symptomatology.