Emotion, as well as cognition, are often understood as a manifestation of brain activity. However, bodily processes are also involved in mental functioning, referring to the concept of embodiment. Embodied emotion, traditionally, implies that experiencing an emotion involves perceptual, somato-visceral, and motor aspects. Within the frame of the Research Training Group “Situated Cognition”, we here extend the concept of embodiment by considering the role of hormones in the processing of emotional content. Importantly, hormones allow a bidirectional body-to-brain and brain-to-body coupling. The endocrine system, e.g., steroid sex hormones, produced in the gonads, send feedback to the brain by binding at their receptors. These receptors are relatively abundant in the brain regions associated with emotional processing, memory, and executive functions (i.e., amygdala, hippocampus, and prefrontal cortex). Moreover, peripheral hormone secretion is modulated via actions from the central nervous system. We intended to characterize the role of sex hormones, and partly also of stress hormones, on different components of emotion as a hormonal embodiment of emotion. Thus, we examined emotional processing in different sex hormone-status groups. To account for different levels of sex hormones, we used a quasi-experimental approach by comparing women in different cycle phases, women using hormonal oral contraceptives (Study 1), and additionally men (in Study 2). The female menstrual cycle is characterized by fluctuating sex hormone levels. On the peripheral gonadal level, these are 17β-estradiol and progesterone. These hormones are low at the beginning of the cycle (early follicular phase). Estradiol rises towards the middle of the cycle (mid-cycle) and stays moderately high until the next cycle. Progesterone levels are high after mid-cycle in the luteal phase until the end of the cycle. Hormonal contraceptives suppress the endogenous production of estradiol and progesterone, keeping the hormone levels low during the whole cycle. Estradiol and progesterone are also present in males, however, at low levels with no sign of cyclical fluctuations. In Study 1, we examined three independent groups of women in the mid-cycle (n = 24), in the luteal phase (n = 24), and women using hormonal oral contraceptives (n = 24). We assessed different measures of emotional processing, i. e. emotional memory, cognitive and affective empathy-related measures (emotion recognition and ratings for feeling with a protagonist´s emotion, respectively), as well as mimic and skin-conductance responses to affective stimuli. Additionally, we addressed interactions of experimental stress (cold pressor test vs. control) with sex hormones in emotional memory. Our data demonstrated the role of hormones in empathy-related measures and skin-conductance responses depending on the stimulus characteristics (valence, the gender of the protagonist). Emotional memory was not affected by hormone status, stressor or salivary hormone levels. In the cognitive empathy-related measure, women in the luteal phase, as well as oral contraceptive users, identified emotions depicted by female protagonists more accurately than those by male protagonists. On the other hand, estradiol correlated positively with recognition of emotions depicted by males in the total sample. In the affective empathy-related measure, oral contraceptive users rated negative emotions higher than the positive ones. Finally, in the luteal phase skin-conductance responses to negative stimuli were heightened, also supported by a positive correlation with the salivary progesterone levels. The mimic responses remained unaffected. None of the remaining associations with the salivary hormone levels were significant. These results indicate that sex hormones modulated emotional processing by interacting with the stimulus features, as evident in the negativity bias under oral contraceptive use and in the luteal phase in the affective empathy-related measure and sympathetic autonomous reactivity, respectively. However, emotional memory and mimic activity to affective stimuli were not affected. In Study 2, we extended the initial scope to examine the role of sex hormones and olfaction in empathy-related measures. Reports of female advantage in empathy-related measures suggest a role for sex hormones, although data are inconsistent. Studies also report similar sex differences in human olfactory perception. In rodents, olfaction is involved in detecting and integrating socially-relevant information and is modulated by the brain-actions of estrogens. Based on this background, we hypothesized that olfaction may untangle the mixed evidence regarding the relationship between sex hormones and empathy-related measures (cognitive, affective). Thus, we measured odor discrimination ability, empathy-related measures, and facial mimic activity (also associated with affective empathy-related measures) in free-cycling women in high sex-hormone phases (n = 20), oral contraceptive users (n = 19), and men (n = 21). Free-cycling women outperformed only men in the recognition of emotions depicted from the eye region. Oral contraceptive users showed higher scores in the affective empathy-related measure towards negative emotions. Free-cycling women exhibited the strongest facial mimicry (viewing female, but not male protagonists), positively associated with progesterone. Finally, the groups differed in odor discrimination, with free-cycling women outperforming men. However, odor discrimination ability and empathy-related performance were not correlated. Our results support the role of sex hormones in odor perception and empathy-related measures, to a certain extent. However, no common underlying mechanism was found. Finally, we conducted a systematic review (Study 3) aiming to elucidate factors contributing to the inconsistent results concerning the role of sex hormones in the two most addressed areas of emotional processing, emotion recognition (empathy-related measure) and emotional memory. Thereby, we extended previous reviews that address single areas of emotion processing. Moreover, we systematically addressed the role of situational features (mainly emotion-type and/or stimulus valence). All studies included healthy women of reproductive age either in stages of their natural menstrual cycle or using oral contraceptives, and measured or at least estimated levels of ovarian sex hormones. We document the methodological diversity in the field, presumably contributing to the heterogeneity of results. We recognized the need for studies explicitly contrasting the early follicular, mid-cycle, and mid-luteal phases, as well as OC-intake and using standardized tasks. Research would take advantage of using within-subject design more frequently and account for the recognition of complex emotions. In sum, our data suggest that sex hormones differentially modulate the cognitive and affective empathy-related performance and skin-conductance responses by interacting with situational variables, such as the emotional valence of the stimuli and the gender of the protagonist. Women in the luteal phase and under oral contraceptive use demonstrated better recognition of emotions depicted by female protagonists. By contrast, estradiol levels positively correlated with the recognition of emotions depicted by male protagonists. Sex-hormone status main effects only manifested in the emotion recognition advantage of free-cycling women over men (Reading the Mind in The Eyes Test; Study 2). In both studies, affective empathy ratings towards negative emotions were higher in the oral contraceptive users. Moreover, although mimic activity was not associated with sex hormones, skin-conductance responses to negative stimuli were heightened in the luteal phase. On the other hand, the performance in empathy-related measures in different hormone-status groups was not related to odor discrimination ability. Additionally, the inconsistencies of the sex hormone and emotion research could be the result of variations of designs and tasks used across studies from a similar field. This is also indicated in our findings from the empathy-related measures differing in tasks and hormone-status groups in two studies. Finally, our findings provide evidence that emotional processes under sex-hormone modulation are situated, i.e., subject to the influence of the stimulus valence. Furthermore, they are embodied via coupling between the endocrine system and the brain as evident in hormone status and valence interactions in empathy-related measures and sympathetic reactivity.

Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.

Σκοπός: η μελέτη της επίδρασης εξάμηνης θεραπείας με από του στόματος αντισυλληπτικό δισκίο περιέχον 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης στη γλοιότητα πλάσματος νέων γυναικών με σύνδρομο πολυκυστικών ωοθηκών. Σχεδίαση: Η γλοιότητα πλάσματος μετρήθηκε σε ασθενείς με σύνδρομο πολυκυστικών ωοθηκών πριν και 6 μήνες μετά από τη χορήγηση αντισυλληπτικού δισκίου περιέχοντος 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης. Η μέτρηση της γλοιότητας έγινε σε ιξωδόμετρο τύπου 53610/I SCHOTT-Instruments, Mainz στους 37ο C. Ασθενείς: Οι ασθενείς στρατολογήθηκαν από το τμήμα Αναπαραγωγικής Ενδοκρινολογίας της Μαιευτικής - Γυναικολογικής Κλινικής του Πανεπιστημιακού Νοσοκομείου Πατρών Ελλάδας. Στη μελέτη περιλήφθηκαν 66 νέες γυναίκες με σύνδρομο πολυκυστικών ωοθηκών. Βασικοί προσδιορισμοί: Γλοιότητα πλάσματος Αποτελέσματα: Στις ασθενείς ως σύνολο, η γλοιότητα πλάσματος ήταν 1.249±0.049 mm2/s (n=66). Μετά από 6 μήνες θεραπείας με από του στόματος αντισυλληπτικό δισκίο περιέχον 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης, η γλοιότητα πλάσματος αυξήθηκε σε 1.268±0.065 mm2/s (p=0.038). Η διαφορά στη γλοιότητα πλάσματος πριν και 6 μήνες μετά τη θεραπεία (Δ Γλοιότητας) ήταν 0,01864±,071452 mm2/s. Η Δ Γλοιότητας σχετιζόταν με τη Δ Ινωδογόνου (r=0.270, p=0.046), τη Δ Αιματοκρίτη (r=0.514, p=0.09) και τη Δ Τριγλυκεριδίων (r=0.292, p=0.021). Συμπέρασμα: Νέες γυναίκες με σύνδρομο πολυκυστικών ωοθηκών εμφάνισαν αυξημένη γλοιότητα πλάσματος μετά από θεραπεία με από του στόματος αντισυλληπτικό, το οποίο θα πρέπει για το λόγο αυτό να χρησιμοποιείται με προσοχή στον εν λόγω πληθυσμό. / Objectives: To investigate the influence of 6 months of treatment with an oral contraceptive (OC) containing 35μg ethinyl estradiol and 2mg cyproterone acetate on plasma viscosity in young women with PCOS. Design: PCOS patients were assessed for plasma viscosity before and after 6 months of treatment with an OC containing 35μg ethinyl estradiol and 2mg cyproterone acetate. Plasma viscosity was determined by a viscometer Type 53610/I SCHOTT-Instruments, Mainz at 37o C. Settings: Subjects were recruited from the Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology at the University Hospital of Patras, Greece. Patients: The study included 66 young PCOS women. Main Outcome measures: Plasma viscosity. Results: In PCOS women as a whole, plasma viscosity at baseline was 1.249±0.049 mm2/s (n=66). After 6 months of treatment with an oral contraceptive containing 35μg ethinyl estradiol and 2mg cyproterone acetate, plasma viscosity increased to 1.268±0.065 mm2/s (p=0.038). The difference between plasma viscosity before and after 6 months of treatment with an oral contraceptive containing 35μg ethinyl estradiol and 2mg cyproterone acetate (Δviscosity) was 0,01864±,071452 mm2/s. Δviscosity was related to Δfibrinogen (r=0.270, p=0.046), to Δhaematocrit (r=0.514, p=0.09) and to Δtriglycerides (r=0.292, p=0.021). Conclusion: Young PCOS women presented an increased plasma viscosity under OC treatment, which therefore should be used with caution.

Objetivo: O objetivo deste estudo foi avaliar em mulheres com tumores císticos de ovário, a proporção que, somente com o tratamento clínico e/ou punção, não necessitaram de cirurgia; a influência da medicação e das doenças associadas na indicação de cirurgia e se a punção reduziu significativamente o tamanho dos cistos. Casuística e métodos: Selecionaram-se 71 mulheres com idade entre 19 e 70 anos de idade, portadoras de tumores císticos de ovário maior que 5 cm, com características de benignidade ao ultra-som transvaginal com Doppler colorido e pulsado e com perfil endócrino e marcadores séricos tumorais normais. Foram divididas em cinco grupos: 1) Grupo A: 15 mulheres que fizeram uso de acetato de noretisterona; 2) Grupo B: 13 mulheres que fizeram uso de acetato de medroxiprogesterona; 3) Grupo C: 14 mulheres que utilizaram contraceptivo oral; 4) Grupo D: 15 mulheres que foram tratadas com análogo de GnRH e 5) Grupo E: 14 mulheres que não fizeram uso de medicação. Todos os grupos foram acompanhados por um ano. No final do primeiro trimestre, se o cisto persistiu, foi realizada a punção. No final do segundo trimestre, se houve recidiva do cisto, foi indicada cirurgia. As pacientes tiveram alta após um ano de acompanhamento com o tratamento do cisto concluído. Resultados: Não houve diferenças significantes entre os cinco grupos. Constatou-se que a condição de uso de medicação para doença associada teve influência significativa no resultado dos tratamentos. Verificou-se que a redução do tamanho do cisto com a punção foi efetiva após 9 meses de acompanhamento. Observou-se que 7% das mulheres tiveram indicação direta para cirurgia sem a punção, portanto, a proporção de recidiva da punção foi de 19,3% enquanto a porcentagem de mulheres que não fizeram a cirurgia foi de 73,2%. Conclusão: A proporção de mulheres que responderam adequadamente somente com o tratamento clínico e/ou a punção, não necessitando pois de cirurgia foi de 73,2%. A influência da medicação/ doença associada no tratamento não cirúrgico foi significativa. A redução do tamanho dos cistos benignos em função do tratamento instituído incluindo a punção foi significativa, a qual foi observada após 9 meses de tratamento. / Objectives: To evaluate the rate of women with ovarian cystic tumors submitted to diferent regimens of hormonal treatment and/or aspiration that didn’t need surgery. To access the effectiveness of ovarian cyst aspiration guided by ultrasonography (USG) and to study the influence of medication and associated diseases in the need for surgery. Patients and Methods: Seventy one (71) women, in an age range from 19 to 70 years, diagnosed with ovarian cysts larger than 5 cm in length, with benign aspect, examined using an ultrasonographic transvaginal probe and color Doppler. All the women have been submitted to measurements of ser um tumor markers and hormonal levels. They were grouped in five different categories: 1) Group A: 15 women treated with noretisterone acetate; 2) Group B: 13 subjects treated with medrooxiprogesterone acetate; 3) Group C: 14 patients treated with combined oral contraceptive; 4) Group D: 15 women treated with GnRH analog, and 5) Group E: 15 women with no treatment control). After 3 months, all the patients were reevaluated. In those ones whose cysts remained, cyst aspiration guided by ultrasonography was indicated. After 3 extra months, the women were submitted to a new USG examination and in those whose cysts still remained, surgery was performed. All the patients were followed for one year. Results: There was no significant difference among the groups of hormonal treatment. The use of medication promoted a significant influence in the treatment outcomes. We also noted that the cyst aspiration was effective in reducing the size of the cysts after 9 months of follow up. Seven per cent (7%) of the patients have had immediate indication for surgery. Among those who was submitted to cyst aspiration, 19.3% had to be resubmitted to treatment because of re-incidence of the cyst, whereas, 73.2% avoid the need for surgery. Conclusions: The proportion of subjects treated with hormones and/or cyst aspiration, with no need for surgery, was of 73.2%. The influence of medication/associated disease in the treatments without surgery was significant. The reduction of size of the cysts because of the hormonal and/or aspiration treatment was significant, which was observed after 9 months of therapy.

Objetivo: O objetivo deste estudo foi avaliar em mulheres com tumores císticos de ovário, a proporção que, somente com o tratamento clínico e/ou punção, não necessitaram de cirurgia; a influência da medicação e das doenças associadas na indicação de cirurgia e se a punção reduziu significativamente o tamanho dos cistos. Casuística e métodos: Selecionaram-se 71 mulheres com idade entre 19 e 70 anos de idade, portadoras de tumores císticos de ovário maior que 5 cm, com características de benignidade ao ultra-som transvaginal com Doppler colorido e pulsado e com perfil endócrino e marcadores séricos tumorais normais. Foram divididas em cinco grupos: 1) Grupo A: 15 mulheres que fizeram uso de acetato de noretisterona; 2) Grupo B: 13 mulheres que fizeram uso de acetato de medroxiprogesterona; 3) Grupo C: 14 mulheres que utilizaram contraceptivo oral; 4) Grupo D: 15 mulheres que foram tratadas com análogo de GnRH e 5) Grupo E: 14 mulheres que não fizeram uso de medicação. Todos os grupos foram acompanhados por um ano. No final do primeiro trimestre, se o cisto persistiu, foi realizada a punção. No final do segundo trimestre, se houve recidiva do cisto, foi indicada cirurgia. As pacientes tiveram alta após um ano de acompanhamento com o tratamento do cisto concluído. Resultados: Não houve diferenças significantes entre os cinco grupos. Constatou-se que a condição de uso de medicação para doença associada teve influência significativa no resultado dos tratamentos. Verificou-se que a redução do tamanho do cisto com a punção foi efetiva após 9 meses de acompanhamento. Observou-se que 7% das mulheres tiveram indicação direta para cirurgia sem a punção, portanto, a proporção de recidiva da punção foi de 19,3% enquanto a porcentagem de mulheres que não fizeram a cirurgia foi de 73,2%. Conclusão: A proporção de mulheres que responderam adequadamente somente com o tratamento clínico e/ou a punção, não necessitando pois de cirurgia foi de 73,2%. A influência da medicação/ doença associada no tratamento não cirúrgico foi significativa. A redução do tamanho dos cistos benignos em função do tratamento instituído incluindo a punção foi significativa, a qual foi observada após 9 meses de tratamento. / Objectives: To evaluate the rate of women with ovarian cystic tumors submitted to diferent regimens of hormonal treatment and/or aspiration that didn’t need surgery. To access the effectiveness of ovarian cyst aspiration guided by ultrasonography (USG) and to study the influence of medication and associated diseases in the need for surgery. Patients and Methods: Seventy one (71) women, in an age range from 19 to 70 years, diagnosed with ovarian cysts larger than 5 cm in length, with benign aspect, examined using an ultrasonographic transvaginal probe and color Doppler. All the women have been submitted to measurements of ser um tumor markers and hormonal levels. They were grouped in five different categories: 1) Group A: 15 women treated with noretisterone acetate; 2) Group B: 13 subjects treated with medrooxiprogesterone acetate; 3) Group C: 14 patients treated with combined oral contraceptive; 4) Group D: 15 women treated with GnRH analog, and 5) Group E: 15 women with no treatment control). After 3 months, all the patients were reevaluated. In those ones whose cysts remained, cyst aspiration guided by ultrasonography was indicated. After 3 extra months, the women were submitted to a new USG examination and in those whose cysts still remained, surgery was performed. All the patients were followed for one year. Results: There was no significant difference among the groups of hormonal treatment. The use of medication promoted a significant influence in the treatment outcomes. We also noted that the cyst aspiration was effective in reducing the size of the cysts after 9 months of follow up. Seven per cent (7%) of the patients have had immediate indication for surgery. Among those who was submitted to cyst aspiration, 19.3% had to be resubmitted to treatment because of re-incidence of the cyst, whereas, 73.2% avoid the need for surgery. Conclusions: The proportion of subjects treated with hormones and/or cyst aspiration, with no need for surgery, was of 73.2%. The influence of medication/associated disease in the treatments without surgery was significant. The reduction of size of the cysts because of the hormonal and/or aspiration treatment was significant, which was observed after 9 months of therapy.

Made available in DSpace on 2016-06-02T20:18:16Z (GMT). No. of bitstreams: 1 4184.pdf: 13787055 bytes, checksum: 434e5f6a43d2ae2b1233af9adab7c137 (MD5) Previous issue date: 2012-02-23 / Financiadora de Estudos e Projetos / The aim of Study 1 was to evaluate the effects of using oral contraceptives (OC) on the hip and knee kinematics of healthy women during single-leg squat. Forty two volunteers were divided into two groups: women who had used OC (n= 21) and women who did not use OC (n= 21). The knee abduction/adduction, hip abduction/adduction and medial/lateral rotation excursions (maximum and at 75º of knee flexion) were calculated for the dominant limb during single-leg squat. No significant difference was verified between the groups regarding the maximum excursion of knee abduction (p= 0.26) or hip adduction (p= 0.10) and medial rotation (p= 0.94). When considering the knee flexion at 75º, no significant difference was verified between the groups regarding the excursion of knee abduction (p= 0.31) or hip adduction (p= 0.11) and medial rotation (p= 0.85). These results suggest that the use of OC does not influence the hip and knee kinematics during single-leg squat. As a complement, the aim of Study 2 was to evaluate the effects of using OC on the hip and knee kinematics of healthy women during anterior stair descent. Forty volunteers were divided into two groups: women who had used OC (n= 20) and 2 - women who did not use OC (n= 20). The knee abduction/adduction, hip abduction/adduction and medial/lateral rotation excursions were calculated for the dominant (supporting) limb during anterior stair descent. No significant difference was verified between the groups regarding the maximum excursion of knee abduction (p= 0.58) or hip adduction (p= 0.29) and medial rotation (p= 0.42). When considering the knee flexion at 50º, no significant difference was verified between the groups regarding the excursion of knee abduction (p= 0.92) or hip adduction (p= 0.50) and medial/lateral rotation (p= 0.19). These results suggest that the use of OC does not influence the hip and knee kinematics during anterior stair descent. The aim of Study 3 was to verify the effects of eight-week plyometric training (PT) on hip and knee kinematics and on eccentric hip and knee torques, as well as on lower limb functional performance in healthy women. Thirty-six females were divided into a training group (TG; n= 18), and a control group (CG; n= 18). Kinematic analyses of the hip and knee was carried out during the single-leg squat and the functional performance was evaluated by way of the triple hop (TH) test and the six-meter timed hop (STH) test. The eccentric hip abductor, adductor, lateral rotator and medial rotator as well as the knee flexor and extensor torques/body weight were measured using an isokinetic dynamometer. After 8 weeks, the TG showed a decrease in maximum excursion to knee abduction (p= 0.009) and in maximum excursion to hip adduction (p<0.001), as well as in the excursion to hip adduction at 75º of knee flexion (p=0.002). Moreover, the TG significantly increased the values obtained in the TH test (p=0.05) and significantly decreased those obtained in the STH test (p<0.001) after intervention. However, there was no significant change on hip and knee eccentric torques. Thus, eight weeks of PT were effective to improve hip and knee kinematics and functional performance of women in hop tests. However this was apparently not an effective method to promote strengthening of the hip and knee muscles when used alone / O objetivo do Estudo 1 foi avaliar o efeito do uso dos contraceptivos orais (CO) na cinemática do quadril e do joelho durante o agachamento unipodal em mulheres sadias. Quarenta e duas voluntárias foram divididas em dois grupos: que utilizavam (n=21) ou não (n=21) os CO. As excursões (máximas e no ângulo de 75º de flexão do joelho) em abdução/adução do joelho, em abdução/adução do quadril e em rotação medial/lateral do quadril foram verificadas durante a realização do agachamento unipodal com o membro inferior dominante. Não houve diferença significativa entre os grupos quanto à máxima excursão em abdução do joelho (p=0,26) e em adução (p=0,10) e rotação medial (p=0,94) do quadril. Quando considerado o ângulo de 75º de flexão do joelho, nenhuma diferença significativa foi verificada entre os grupos para os valores de excursão em abdução do joelho (p=0,31) e em adução (p=0,11) e rotação medial (p=0,85) do quadril. Estes achados sugerem que o uso de CO não influencia a cinemática do joelho e do quadril durante a realização do agachamento unipodal. De forma complementar, o Estudo 2 teve por objetivo avaliar os efeitos do uso de CO na cinemática do quadril e do joelho de mulheres sadias durante a descida anterior de degraus. Quarenta voluntárias foram divididas em dois grupos: que utilizavam (n=20) ou não (n=20) os CO. As excursões em abdução/adução do joelho, abdução/adução do quadril e rotação medial/lateral do quadril foram calculadas para o membro dominante durante a descida anterior de degraus. Nenhuma diferença significativa foi verificada entre os grupos para a excursão máxima em abdução do joelho (p=0,58) ou em adução (p=0,29) e rotação medial (p=0,42) do quadril. Quando considerado o ângulo de flexão do joelho de 50º, nenhuma diferença foi verificada entre os grupos para a excursão em abdução do joelho (p=0,92) ou em adução (p=0,50) e rotação medial/lateral (p=0,19) do quadril. Estes resultados sugerem que o uso de CO não influencia a cinemática do quadril e do joelho durante a descida anterior de degraus. A proposta do Estudo 3 foi verificar os efeitos do treinamento pliométrico (TP) de 8 semanas na cinemática e no torque excêntrico do quadril e do joelho, bem como sobre o desempenho funcional do membro inferior de mulheres sadias. Trinta e seis mulheres foram divididas em dois grupos: 1) grupo treinamento (GT; n=18) e 2) grupo controle (GC; n=18). A análise cinemática do quadril e do joelho foi realizada durante o agachamento unipodal e o desempenho funcional foi avaliado por meio do salto triplo unipodal (STU) e pelo salto unipodal em 6 metros cronometrado (SUC). A relação torque excêntrico abdutor, adutor, rotador lateral e rotador medial do quadril/massa corporal e o torque excêntrico flexor e extensor do joelho/massa corporal foram mensurados por meio de um dinamômetro isocinético. Após 8 semanas, o GT apresentou diminuição da excursão máxima em abdução do joelho (p=0,009) e em adução do quadril (p<0,001), bem como da excursão em adução do quadril a 75º de flexão do joelho (p=0,002). Além disso, o GT apresentou melhora no desempenho funcional para o STU (p=0,05) e para o SUC (p<0,001). Entretanto, não houve modificação significativa nos torques excêntricos do quadril e do joelho. Deste modo, o TP oito semanas foi eficiente para induzir alterações positivas de ordem cinemática e funcional nas mulheres avaliadas. Contudo, não apresentou eficiência para promover o fortalecimento dos músculos do quadril o joelho

Abstract Depression, anxiety and sleep disorders have been reported to be associated with low level of inflammation, i.e., low-grade inflammation, but mainly in males. The evidence has mainly been based on laboratory or clinical studies with small sample sizes or epidemiological studies with elderly subpopulations. In this study the association of low-grade inflammation with depression, anxiety, and sleep disturbances was investigated using the Northern Finland 1966 Birth Cohort (NFBC 1966). In women, the effect of hormonal factors, menopause and the use of oral contraceptives/hormone replacement therapy on the association between low-grade inflammation and depression was also studied by using the Pieksämäki Study data. In 31-year follow-up of NFBC 1966 (N=6007), the depressive and anxiety symptoms were assessed by Hopkins Symptom Checklist-25 (HSCL-25) and sleep disorders by 15-D questionnaires, while the marker of low-grade inflammation, plasma concentration of high sensitivity C-reactive protein (hs-CRP), was measured. In the Pieksämäki study a representative sample of inhabitants in the town of Pieksämäki were invited to clinical examination. Depressive symptoms were obtained by Beck’s Depression Inventory-21, and hs-CRP was measured (512 women). The results of this study revealed that at epidemiological level, elevated hs CRP levels of &#8805;1.0 mg/L increased the probability of current depressive symptoms of single depressive episode in the two highest subgroups (i.e., HSCL-25 mean scores &#8805;1.75 and &#8805;2.01) 1.4- and 1.7- fold in males, respectively. In addition, anxiety symptoms (HSCL-25 anxiety scale mean score &#8805;1.75) increased independently the probability of elevated hs-CRP levels (&#62;3.0 mg/L) in males over 2-fold. Risk ratio of 1.3 was found for males with moderate to severe sleep disturbances and elevated hs-CRP levels (&#8805;1.0 mg/L). Regarding females, a positive correlation between elevated hs-CRP levels and depressive symptoms was found only among peri- and postmenopausal women not using exogenous hormones. The results suggest that low-grade inflammation is associated not only with depression but also with anxiety and sleep disturbances in young adult men. In women, hormonal factors may have an effect on the association between low-grade inflammation and depression. Further investigations are called for to confirm these findings and furthermore, to determine the possible role of low-grade inflammation in the pathophysiology of these disorders. / Tiivistelmä Depressio, ahdistuneisuushäiriöt ja unihäiriöt on yhdistetty elimistön matala-asteiseen tulehdustilaan, joskin pääasiallisesti vain miehillä. Tulosten yleistettävyyttä ovat rajoittaneet tutkimusten pienet otoskoot tai painottuminen iäkkäisiin väestöaineistoihin. Tässä tutkimuksessa selvitettiin matala-asteisen tulehduksen yhteyttä depressioon, ahdistuneisuuteen ja unihäiriöihin Pohjois-Suomen syntymäkohortti 1966 -aineistossa. Lisäksi Pieksämäki-tutkimuksen aineistossa selvitettiin naisilla menopaussin ja ehkäisyvalmisteiden/vaihdevuosihormonikorvaushoidon vaikutusta depression ja matala-asteisen tulehduksen väliseen yhteyteen. Pohjois-Suomen syntymäkohortti 1966 -tutkimuksen 31-vuotisseurannassa kartoitettiin 6007 henkilöltä masennus- ja ahdistuneisuusoireita Hopkins Symptom Checklist-25 -arviointiasteikolla (HSCL-25) ja unihäiriöitä 15-D-kyselyllä. Lisäksi mitattiin matala-asteisen tulehduksen mittarina käytetyn herkän C-reaktiivisen proteiinin (CRP) pitoisuus. Pieksämäki-tutkimuksessa edustava otos Pieksämäen asukkaista kutsuttiin kliiniseen tutkimukseen ja depressiivisiä oireita kartoitettiin Beckin 21-osioisella arviointiasteikolla ja mitattiin herkkä CRP (512 naista). Nuorilla aikuisilla miehillä, joiden herkkä CRP oli kohonnut (&#8805;1.0 mg/l), todettiin 1.7-kertainen masennusoireiden riski, kun katkaisupisteenä käytettiin HSCL-25-kyselyn masennuskeskiarvopistettä &#8805;2.01. Ahdistuneisuusoireet (HSCL-25-kyselyn ahdistuneisuuskeskiarvopisteet &#8805;1.75) lisäsivät kohonneen herkän CRP:n riskiä (&#62;3.0 mg/l) yli kaksinkertaiseksi miehillä. Keskivaikeasta tai vaikeasta unihäiriöstä kärsivillä todettiin 1.3-kertainen kohonneen herkän CRP:n (&#8805;1.0 mg/l) riski. Naisilla positiivinen yhteys masennuksen ja kohonneen herkän CRP:n välillä todettiin vain peri- ja postmenopausaalisilla naisilla, jotka eivät käyttäneet hormonikorvaushoitoa tai suun kautta otettavia ehkäisyvalmisteita. Tutkimustulokset viittaavat matala-asteisen tulehduksen liittyvän depressioon, ahdistukseen ja unihäiriöön nuorilla aikuisilla miehillä. Naisilla hormonaaliset seikat mahdollisesti vaikuttavat depression ja matala-asteisen tulehduksen väliseen yhteyteen. Tulevaisuuden tutkimushaasteena on selvittää matala-asteisen inflammaation mahdollinen merkitys depression, ahdistuneisuuden ja unihäiriöiden patofysiologiassa.

No description available.

No description available.

Objectif : Étudier l'association entre l’utilisation de contraceptifs hormonaux et le risque d'acquisition du VIH-1 chez les femmes au Malawi, en Afrique du Sud, en Zambie et au Zimbabwe. Devis : Analyses secondaires de 2887 femmes âgées de 17-55 ans ayant participé à l’étude HPTN 035, une étude de phase II/IIb sur l’efficacité de deux gels microbicides pour prévenir la transmission du VIH chez les femmes à risque. Méthodes : L'association entre l'utilisation de contraceptifs hormonaux et le risque d'acquisition du VIH-1 a été évaluée en utilisant des modèles de Cox. Des risques relatifs sont estimés où le groupe de référence est celui des femmes qui n’utilisent pas de contraceptifs hormonaux. De plus, un modèle multivarié de Cox est utilisé afin de contrôler pour les facteurs potentiellement confondants. Résultats : Les contraceptifs injectables ont été utilisés par 52,1% des femmes, alors que les contraceptifs oraux ont été utilisés par 20,7% de celles-ci. Pendant l'étude, il y a eu 192 séroconversions. L'incidence observée du VIH était de 2,28; 4,19 et 4,69 pour 100 personne-années pour les contraceptifs oraux, injectables et non hormonaux, respectivement. Lors de l’analyse multivariée, nous n'avons trouvé aucune association significative entre l’usage des contraceptifs hormonaux et l’acquisition du VIH-1. Le risque relatif ajusté (RRa) pour les contraceptifs oraux est de 0,573 (IC de 95% : [0,31-1,06]) et 0,981 (IC de 95% : [0,69 ; 1,39]) pour les contraceptifs injectables. Conclusions : Bien que cette étude ne démontre pas d’association entre l’usage des contraceptifs hormonaux et le VIH-1, nous concluons toutefois que ces méthodes de contraception ne protègent pas contre le VIH-1, et il est ainsi recommandé aux femmes utilisant des hormones contraceptives de toujours utiliser le condom pour prévenir l'infection au VIH-1. / Objective: To investigate the association between the use of hormonal contraceptive and the risk of acquiring HIV-1 infection in women from Malawi, South Africa, Zambia and Zimbabwe. Design: Secondary analyses of 2887 women aged 17-55 years who participated in the HPTN 035 trial, a Phase II/IIb trial on the efficacy of two microbicide gels to prevent HIV transmission in women at risk in Africa. Methods: The association between the use of hormonal contraceptive and the risk of acquiring HIV-1 was evaluated using Cox proportionnal models. Relative risks of exposed women were estimated using as a reference group the women who do not use hormonal contraceptives. In addition, a multivariate Cox model was used to control for potentially confounding factors. Results: Injectable contraceptives were used by 52.1 % of women, while oral contraceptives were used by 20.7% of them. During the study, there were 192 seroconversions. The observed HIV-1 incidence was 2.28, 4.19 and 4.69 per 100 woman-years for oral, injectable and non-hormonal contraceptive users, respectively. In multivariate analysis, we found no significant association between the use of hormonal contraceptives and HIV-1 acquisition. The adjusted relative risk (aRR) for oral contraceptives was 0.573 (95% CI: [0.31 to 1.06]) and 0.981 (95% CI: [0.69, 1.39]) for injectable contraceptives. Conclusions: Although this study did not demonstrate an association between hormonal contraceptive use and the risk of HIV-1 infection, we conclude, however, that these methods of contraception do not protect against HIV-1, and it is thus recommended that women using contraceptive hormones always use condoms to prevent HIV-1.