Clinical Capsules

Children of Preeclamptic Mothers

Children born to preeclamptic mothers are more likely to have pulmonary hypertension, compared with children born from uncomplicated pregnancies, according to a study presented at a meeting sponsored by the American Physiological Society.

The finding provides “the very first evidence that preeclampsia leaves a persistent and potentially fatal imprint in the pulmonary circulation of the offspring,” said Pierre-Yves Jayet, M.D.

Dr. Jayet and his associates hypothesized that children born to mothers who had preeclampsia are predisposed to pulmonary hypertension at high altitude. To test this hypothesis, the investigators used echocardiography to measure systolic pulmonary artery pressure in 11 children aged 6–8 years who were born to preeclamptic mothers from La Paz, Bolivia, where the elevation is 12,000–13,000 feet above sea level. For a control group, they evaluated 13 age- and gender-matched children in La Paz born from normal pregnancies, said Dr. Jayet of University Hospital, Lausanne, Switzerland.

The mean systolic pulmonary artery pressure was about 33% higher in children born to preeclamptic mothers, compared with those born from uncomplicated pregnancies (36 mm Hg vs. 27 mm Hg, respectively). Hypoxic pulmonary vasoconstriction was not related to more severe hypoxemia or exaggerated polyglobulia, Dr. Jayet noted. The Swiss National Science Foundation supported the study.

Emotional Writing Helps Fibromyalgia

Fibromyalgia patients demonstrated short-term improvement in psychological well-being, fatigue, and pain by writing about personal traumatic experiences, reported Joan E. Broderick, Ph.D., of the State University of New York at Stony Brook. Women at an average age of 50 years who reported an onset of fibromyalgia about 9 years before the study were randomized into three groups: 31 in the emotional-disclosure (ED) group, 32 in the neutral-writing (NW) group, and 29 in the usual-care (UC) group. Those in the ED group wrote about personal traumatic experiences in three lab sessions; those in the NW group wrote about day-to-day activities over three lab sessions (Psychosom. Med. 2005;67:326–34).

Psychological well-being, fatigue, and pain were assessed at pretreatment, 4-month follow-up, and 10-month follow-up. Since no significant differences were found from pretreatment and 4-month follow-up in the NW and UC groups, they were combined into a single control group, the investigators said. At 4 months, the ED group showed a significant reduction in fatigue and pain and improvements in psychological well-being, compared with controls. But none of the benefits were sustained at 10-month follow-up.

Larger Fibroids, Heavy Bleeding

Heavy bleeding in women with fibroids was significantly associated with increased fibroid volume but not pelvic pain, according to Kristen Kjerulff, Ph.D., of Pennsylvania State University, Hershey, and colleagues. In a linear regression analysis of 714 premenopausal women with fibroids, the number of days of heavy bleeding was significantly associated with increased uterine volume but not with pelvic pain, they wrote in a poster presented at an international conference sponsored by the National Institutes of Health.

In addition, intramural fibroids were associated with both excessive bleeding and pelvic pain; submucosal fibroids were associated with excessive bleeding but not with pelvic pain. The presence of at least seven fibroids was significantly associated with frequent abdominal bloating.

The women were interviewed regarding risk factors, symptom severity, and other quality of life measures. Assessment of fibroids was conducted with transvaginal ultrasound for nonhysterectomy patients and pathology for hysterectomy patients.

HSV-2 Shedding Risk

Hormonal contraception and two common genital tract conditions appear to be among the risk factors for shedding of herpes simplex virus type 2 in women.

In a 12-month study of 330 women who were evaluated every 4 months, independent predictors of genital tract shedding of HSV-2 were HSV-2 seroconversion during the previous 4 months (adjusted odds ratio [OR] 3.0), bacterial vaginosis (adjusted OR 2.3), heavy colonization with group B streptococcus (adjusted OR 2.2), and use of hormonal contraceptives (adjusted OR 1.8), reported Thomas L. Cherpes, M.D., and his colleagues at the University of Pittsburgh (Clin. Infect. Dis. 2005;40:1422–8).

Because use of hormonal contraception is widespread, and bacterial vaginosis and vaginal group B streptococcus colonization are two of the most common genital conditions in women of reproductive age, the associations between these variables and increased genital tract shedding of HSV-2 is of concern.

Children of Preeclamptic Mothers

Children born to preeclamptic mothers are more likely to have pulmonary hypertension, compared with children born from uncomplicated pregnancies, according to a study presented at a meeting sponsored by the American Physiological Society.

The finding provides “the very first evidence that preeclampsia leaves a persistent and potentially fatal imprint in the pulmonary circulation of the offspring,” said Pierre-Yves Jayet, M.D.

Dr. Jayet and his associates hypothesized that children born to mothers who had preeclampsia are predisposed to pulmonary hypertension at high altitude. To test this hypothesis, the investigators used echocardiography to measure systolic pulmonary artery pressure in 11 children aged 6–8 years who were born to preeclamptic mothers from La Paz, Bolivia, where the elevation is 12,000–13,000 feet above sea level. For a control group, they evaluated 13 age- and gender-matched children in La Paz born from normal pregnancies, said Dr. Jayet of University Hospital, Lausanne, Switzerland.

The mean systolic pulmonary artery pressure was about 33% higher in children born to preeclamptic mothers, compared with those born from uncomplicated pregnancies (36 mm Hg vs. 27 mm Hg, respectively). Hypoxic pulmonary vasoconstriction was not related to more severe hypoxemia or exaggerated polyglobulia, Dr. Jayet noted. The Swiss National Science Foundation supported the study.

Emotional Writing Helps Fibromyalgia

Fibromyalgia patients demonstrated short-term improvement in psychological well-being, fatigue, and pain by writing about personal traumatic experiences, reported Joan E. Broderick, Ph.D., of the State University of New York at Stony Brook. Women at an average age of 50 years who reported an onset of fibromyalgia about 9 years before the study were randomized into three groups: 31 in the emotional-disclosure (ED) group, 32 in the neutral-writing (NW) group, and 29 in the usual-care (UC) group. Those in the ED group wrote about personal traumatic experiences in three lab sessions; those in the NW group wrote about day-to-day activities over three lab sessions (Psychosom. Med. 2005;67:326–34).

Psychological well-being, fatigue, and pain were assessed at pretreatment, 4-month follow-up, and 10-month follow-up. Since no significant differences were found from pretreatment and 4-month follow-up in the NW and UC groups, they were combined into a single control group, the investigators said. At 4 months, the ED group showed a significant reduction in fatigue and pain and improvements in psychological well-being, compared with controls. But none of the benefits were sustained at 10-month follow-up.

Larger Fibroids, Heavy Bleeding

Heavy bleeding in women with fibroids was significantly associated with increased fibroid volume but not pelvic pain, according to Kristen Kjerulff, Ph.D., of Pennsylvania State University, Hershey, and colleagues. In a linear regression analysis of 714 premenopausal women with fibroids, the number of days of heavy bleeding was significantly associated with increased uterine volume but not with pelvic pain, they wrote in a poster presented at an international conference sponsored by the National Institutes of Health.

In addition, intramural fibroids were associated with both excessive bleeding and pelvic pain; submucosal fibroids were associated with excessive bleeding but not with pelvic pain. The presence of at least seven fibroids was significantly associated with frequent abdominal bloating.

The women were interviewed regarding risk factors, symptom severity, and other quality of life measures. Assessment of fibroids was conducted with transvaginal ultrasound for nonhysterectomy patients and pathology for hysterectomy patients.

HSV-2 Shedding Risk

Hormonal contraception and two common genital tract conditions appear to be among the risk factors for shedding of herpes simplex virus type 2 in women.

In a 12-month study of 330 women who were evaluated every 4 months, independent predictors of genital tract shedding of HSV-2 were HSV-2 seroconversion during the previous 4 months (adjusted odds ratio [OR] 3.0), bacterial vaginosis (adjusted OR 2.3), heavy colonization with group B streptococcus (adjusted OR 2.2), and use of hormonal contraceptives (adjusted OR 1.8), reported Thomas L. Cherpes, M.D., and his colleagues at the University of Pittsburgh (Clin. Infect. Dis. 2005;40:1422–8).

Because use of hormonal contraception is widespread, and bacterial vaginosis and vaginal group B streptococcus colonization are two of the most common genital conditions in women of reproductive age, the associations between these variables and increased genital tract shedding of HSV-2 is of concern.

Children of Preeclamptic Mothers

Children born to preeclamptic mothers are more likely to have pulmonary hypertension, compared with children born from uncomplicated pregnancies, according to a study presented at a meeting sponsored by the American Physiological Society.

The finding provides “the very first evidence that preeclampsia leaves a persistent and potentially fatal imprint in the pulmonary circulation of the offspring,” said Pierre-Yves Jayet, M.D.

Dr. Jayet and his associates hypothesized that children born to mothers who had preeclampsia are predisposed to pulmonary hypertension at high altitude. To test this hypothesis, the investigators used echocardiography to measure systolic pulmonary artery pressure in 11 children aged 6–8 years who were born to preeclamptic mothers from La Paz, Bolivia, where the elevation is 12,000–13,000 feet above sea level. For a control group, they evaluated 13 age- and gender-matched children in La Paz born from normal pregnancies, said Dr. Jayet of University Hospital, Lausanne, Switzerland.

The mean systolic pulmonary artery pressure was about 33% higher in children born to preeclamptic mothers, compared with those born from uncomplicated pregnancies (36 mm Hg vs. 27 mm Hg, respectively). Hypoxic pulmonary vasoconstriction was not related to more severe hypoxemia or exaggerated polyglobulia, Dr. Jayet noted. The Swiss National Science Foundation supported the study.

Emotional Writing Helps Fibromyalgia

Fibromyalgia patients demonstrated short-term improvement in psychological well-being, fatigue, and pain by writing about personal traumatic experiences, reported Joan E. Broderick, Ph.D., of the State University of New York at Stony Brook. Women at an average age of 50 years who reported an onset of fibromyalgia about 9 years before the study were randomized into three groups: 31 in the emotional-disclosure (ED) group, 32 in the neutral-writing (NW) group, and 29 in the usual-care (UC) group. Those in the ED group wrote about personal traumatic experiences in three lab sessions; those in the NW group wrote about day-to-day activities over three lab sessions (Psychosom. Med. 2005;67:326–34).

Psychological well-being, fatigue, and pain were assessed at pretreatment, 4-month follow-up, and 10-month follow-up. Since no significant differences were found from pretreatment and 4-month follow-up in the NW and UC groups, they were combined into a single control group, the investigators said. At 4 months, the ED group showed a significant reduction in fatigue and pain and improvements in psychological well-being, compared with controls. But none of the benefits were sustained at 10-month follow-up.

Larger Fibroids, Heavy Bleeding

Heavy bleeding in women with fibroids was significantly associated with increased fibroid volume but not pelvic pain, according to Kristen Kjerulff, Ph.D., of Pennsylvania State University, Hershey, and colleagues. In a linear regression analysis of 714 premenopausal women with fibroids, the number of days of heavy bleeding was significantly associated with increased uterine volume but not with pelvic pain, they wrote in a poster presented at an international conference sponsored by the National Institutes of Health.

In addition, intramural fibroids were associated with both excessive bleeding and pelvic pain; submucosal fibroids were associated with excessive bleeding but not with pelvic pain. The presence of at least seven fibroids was significantly associated with frequent abdominal bloating.

The women were interviewed regarding risk factors, symptom severity, and other quality of life measures. Assessment of fibroids was conducted with transvaginal ultrasound for nonhysterectomy patients and pathology for hysterectomy patients.

HSV-2 Shedding Risk

Hormonal contraception and two common genital tract conditions appear to be among the risk factors for shedding of herpes simplex virus type 2 in women.

In a 12-month study of 330 women who were evaluated every 4 months, independent predictors of genital tract shedding of HSV-2 were HSV-2 seroconversion during the previous 4 months (adjusted odds ratio [OR] 3.0), bacterial vaginosis (adjusted OR 2.3), heavy colonization with group B streptococcus (adjusted OR 2.2), and use of hormonal contraceptives (adjusted OR 1.8), reported Thomas L. Cherpes, M.D., and his colleagues at the University of Pittsburgh (Clin. Infect. Dis. 2005;40:1422–8).

Because use of hormonal contraception is widespread, and bacterial vaginosis and vaginal group B streptococcus colonization are two of the most common genital conditions in women of reproductive age, the associations between these variables and increased genital tract shedding of HSV-2 is of concern.