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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Male sexual dysfunction-a term that is commonly used to refer to erectile dysfunction, premature ejaculation, decreased libido and impaired orgasm-is the primary complaint encountered by many urologists. Despite the high prevalence and bothersome nature of these complaints, they are frequently neglected in clinical practice. This paper highlights clinical situations in which urologists should systematically evaluate male sexual functioning. These include men who present with several common urologic disorders, such as pelvic trauma, malignancies, and lower urinary tract symptoms associated with benign prostatic hyperplasia, neurologic disorders and infertility. Studies have shown that erectile dysfunction might be a clinical marker of endothelial dysfunction, and consequently of undetected diabetes, hypertension, dyslipidemia, coronary artery disease and depression. We also address the question of whether urologists should adopt wide-ranging screening regimens for sexual dysfunction.
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PMID:How, why and when should urologists evaluate male sexual function? 1647 Feb 7

Of the thousands of proven carcinogens and toxic agents contained within a cigarette, nicotine, while being the addictive agent, is often viewed as the least harmful of these compounds. Nicotine is a lipophilic molecule whose effects on neuronal nicotinic acetylcholine receptors (nAChR) have been primarily focused on its physiologic impact within the confines of the brain and peripheral nervous system. However, recently, many studies have found neuronal nAChRs to be expressed on many different nonneuronal cell types throughout the body, where increasing evidence suggests they have important roles in determining the consequences of nicotine use on multiple organs systems and diseases as diverse as ulcerative colitis, chronic pulmonary obstructive disease, and diabetes, as well as the neurologic disorders of Parkinson's and Alzheimer's disease. This review highlights current evidence for the expression of peripheral nAChRs in cells other than neurons and how they participate in fundamental processes, such as inflammation. Understanding these processes may offer novel therapeutic strategies to approach inflammatory diseases, as well as precautions in the design of interventional drugs.
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PMID:Neuronal nicotinic acetylcholine receptor expression and function on nonneuronal cells. 1659 41

Aceruloplasminemia is an autosomal recessive neurodegenerative disease characterized by iron accumulation in the brain as well as visceral organs. It is a loss-of-function disorder caused by mutations in the ceruloplasmin gene. Clinically, this disease consists of the triad of adult-onset neurological disease, retinal degeneration and diabetes mellitus. Massive iron accumulation and extensive loss of neurons are observed in the basal ganglia. The elevated iron concentration is associated with increased lipid peroxidation in the brains of aceruloplasminemia patients. Enlarged or deformed astrocytes and spheroid-like globular structures are characteristic neuropathological findings in aceruloplasminemia. Moreover, deformed astrocytes and globular structures react positively to anti-4-hydroxynonenal antibody, suggesting that increased oxidative stress is involved in neuronal cell death in aceruloplasminemia brain. More than 30 aceruloplasminemia-causing mutations in the ceruloplasmin gene have been identified. We examined the biosynthesis of two missense ceruloplasmin proteins that result from a Japanese P177R mutation and a Dutch G631R mutation, using Chinese hamster ovary cell expression system. The P177R mutant protein is retained in the endoplasmic reticulum. The G631R mutant protein, predicted to alter the interactions at a single type I copper-binding site, prevented incorporation of copper into apoceruloplasmin and resulted in the synthesis and secretion only of apoceruloplasmin. Molecular analysis of missense mutations showed different structure-function relationships in ceruloplasmin protein. The investigation of mutant ceruloplasmin reveals new insights into molecular pathogenesis of aceruloplasminemia as well as biosynthesis, trafficking, and function of ceruloplasmin.
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PMID:Molecular and pathological basis of aceruloplasminemia. 1662 61

Bell's palsy is one of the most common neurologic disorders affecting the seventh cranial nerve. Several disease states have been associated with facial paralysis. Drugs, however, have been rarely implicated as an etiology. We describe a 49-year-old man who developed peripheral facial paralysis after 3 weeks of linezolid therapy, along with recurrence of symptoms on rechallenge. He had insulin-dependent diabetes mellitus and a longstanding history of bilateral diabetes-related foot problems. After hospitalization, debridement, and vancomycin therapy for methicillin-resistant Staphylococcus aureus osteomyelitis, the patient was discharged to home with oral linezolid therapy. On day 23 of linezolid therapy, he developed signs and symptoms that were consistent with Bell's palsy. Linezolid was discontinued; the Bell's palsy gradually improved, with complete resolution occurring at month 3. On rechallenge with linezolid for recurrent osteomyelitis, the patient developed a second episode of Bell's palsy within a similar time frame as in the first episode. Assessment of causality using the Naranjo adverse drug reaction probability scale revealed a probable relationship between this adverse drug event and linezolid therapy. Clinicians should be aware that Bell's palsy may be another neuropathic adverse effect associated with linezolid.
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PMID:Bell's palsy associated with linezolid therapy: case report and review of neuropathic adverse events. 1686 96

Comorbid medical illnesses are a key feature of geriatric mood disorders, yet the specificity of such associations remains unclear. In a sample of 546 primary care patients age >or=65 years, pathology in several organ systems (respiratory, eye/ear/nose/throat, gastrointestinal, central nervous system, endocrine) and several chronic conditions (neurological disease, low vision, chronic obstructive pulmonary disease, diabetes) were associated with depression. However, notwithstanding these specific associations, global (overall) medical burden was most powerfully and independently associated with depression, largely independent of functional status. This generates the hypothesis that, in general primary care populations, the relationship of medical illness to depression may be multimodal and/or may involve shared pathobiological or psychosocial mechanisms.
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PMID:The relationship of medical comorbidity and depression in older, primary care patients. 1695 33

Ljungan virus (LV), a new member of the Picornaviridae, recently isolated from vole species in both Sweden and the USA, is suspected to be pathogenic for humans as an aetiological agent in myocarditis, diabetes, neurological disease and perinatal disease. This study describes for the first time an RT-PCR assay that can identify and quantify LV infection in various tissue sample types using primers and two different minor-groove-binder probes targeting the 5'-untranslated region of the LV genome. The assay, evaluated using control samples derived from various virus cultures and rodent tissues, allows precise quantification of viral load over six orders of magnitude (10(1) to 10(6) viral copies per assay) for all known strains of LV with high sensitivity and specificity. Furthermore, a melting curve analysis (MCA) was developed using two amplicon-specific hybridisation probes that allows rapid genotyping of different LV strains. These new methods provide useful tools to investigate the putative role of LV as a pathogen in both rodents and humans.
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PMID:A new quantitative real-time reverse transcriptase PCR assay and melting curve analysis for detection and genotyping of Ljungan virus strains. 1719 65

Reports of dialysis-associated hyperglycemia (DH) were compared to reports of diabetic ketoacidosis (DKA) and nonketotic hyperglycemia (NKH) in patients with preserved renal function. Average serum values in DH (491 observations), DKA (1036 observations), and NKH (403 observations) were as follows, respectively: glucose, 772, 649, and 961 mg/dl; sodium, 127, 134, and 149, mmol/l; and tonicity, 298, 304, and 355 mOsm/kg. Assuming that euglycemic (serum glucose, 90 mg/dl) values were the same (sodium, 140 mmol/l; tonicity, 285 mOsm/kg) for all three states, the hyperglycemic rise in the average serum tonicity value per 100-mg/dl rise in serum glucose concentration was 1.9 mOsm/kg in DH, 3.5 mOsm/kg in DKA, and 8.1 mOsm/kg in NKH. Neurological manifestations in DH patients were caused by coexisting conditions (ketoacidosis, sepsis, and neurological disease) in most instances, and by severe hypertonicity (>320 mOsm/kg), with clearing after insulin administration, in a few instances. In 148 episodes of DH corrected with insulin only, the mean increase in serum sodium per 100-mg/dl decrease in serum glucose (Delta[Na]/Delta[Glu]) was -1.61 mmol/l. In agreement with theoretical predictions, Delta[Na]/Delta[Glu] was numerically smaller in patients with edema than in those with euvolemia. The average hyperglycemic increase in extracellular volume, calculated from changes in serum sodium concentration during correction of DH using insulin alone, was 0.013 l/l per 100-mg/dl increase in serum glucose concentration. A small number of DH patients presented with pulmonary edema rectified by insulin alone. DH causes modest hypertonicity, with few patients having neurological manifestations caused usually by other coexisting conditions. In contrast to DKA or NKH, which usually presents with hypovolemia, DH causes hypervolemia manifested occasionally by pulmonary edema. Insulin is adequate treatment for DH.
J Diabetes Complications
PMID:Body fluid abnormalities in severe hyperglycemia in patients on chronic dialysis: review of published reports. 1819 Oct 75

The results of the administration of the Mini Nutritional Assessment (MNA) of the Elderly to 197 patients (Women: 62.5%; Ages between 60-75 years: 55.4%; Older than 85 years: 9.7%; Whites: 73.7%) consecutively admitted to the Geriatrics Service of the "Hermanos Ameijeiras" Hospital (La Habana, Cuba) are presented. Sixty-nine percent of the patients had between 2 - 7 concurrent health problems. Neoplasms and lymphoproliferative processes (22.8%), heart and blood vessels diseases (15.7%), and infections (12.2%) were prevalent. The state of nutritional anthropometric and biochemical markers was as follows: Body Mass Index < 21 kg x m(-2): 30.9%; Mid-arm Circumference <22 cm: 19.3%; Leg Circumference <31 cm: 42.6%; Serum Albumin <35 g x L(-1): 20.3%. Sixty-eight percent of the patients received scores <24 after administering the MNA. It is to be noticed that 19.3% of the patients was malnourished after receiving scores < 17. MNA scores <24 were concentrated in: Neurological disorders (80.0%), Neoplasms and lymphoproliferative processes (77.8%), heart and blood vessels diseases (74.2%), gastrointestinal disorders (70.6%), infections (69.7%), Diabetes mellitus (66.7%). Patients with the lowest scores also exhibited the lowest values of anthropometric and biochemical markers. MNA score was independent from the patient's sex, skin colour, or number of concurrent health problems. Age had not any influence upon MNA score, although lower scores were observed among the oldest patients. MNA scoring was 80.0% coincident with nutritional diagnosis independently done with anthropometric and biochemical markers used either separately or combined. Aging of the Cuban population, along with increased proportions of elder patients in hospital areas should lead to consider the nutritional status of patients older than 60 years as an important predictor of the success of medical interventions and the quality of medical assistance.
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PMID:[The Mini Nutritional Assessment of the elderly in the practice of a hospital geriatrics service: inception, validation and operational characteristics]. 1827 4

Orthostatic hypotension (OH) is defined as a fall in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic when standing or during head-up tilt testing. The prevalence of OH increases with age, with disorders that affect autonomic nerve transmission, and with increasingly severe orthostatic stress. In normal elderly subjects, the prevalence of OH is reported to be between 5 and 30%. The actual prevalence depends on the conditions during diagnostic testing, such as the frequency of blood pressure recordings, the time of day and the degree of orthostatic stress. Elderly subjects are often taking medications, such as antihypertensives and diuretics that can cause or aggravate OH. Neurological diseases such as diabetic neuropathy, Parkinson's disease, multiple system atrophy and the autonomic neuropathies further increase the likelihood of OH. The development of OH in normal subjects is associated with an increased mortality rate. OH in diabetes is also associated with a significant increase in mortality rate.
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PMID:Prevalence of orthostatic hypotension. 1836 1

The goal of the study was to investigated the prevalence of disability, cognitive impairment, depressive symptomatology and chronic diseases in a sample of the elderly population. A cross-sectional study was carried out on a random sample from the general population of elderly located in a geographically well defined Mediterranean area of Southern Italy. We examined 1339 subjects. Investigated diseases were: chronic obstructive lung disease, hypertension, arthrosis, diabetes mellitus, neurological disease, myocardial infarction, angina, atrial fibrillation, peripheral artery disease and congestive heart failure. Cognitive status was assessed by means of the Mini-Mental State Examination (MMSE), depression symptomatology was evaluated by Geriatric Depression Scale (GDS) and disability by means of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). This methodological study showed that 27.9% had a MMSE score <24 and the score decreased with age in both sexes. A total of 9.8% of the subjects had severe depression (GDS score >20). Comorbidity was evaluated from the past medical history and confirmed by a clinical exam by a physician. Only 8.7% of subjects were found without chronic illness. Median number of diseases was two, with 26.6% declaring four diseases or more. Comorbidity increased with age, an overall slight decrease of the number of diseases being observed in the subjects >85 years old. Subjects disabled in ADL were 7%, while disabled in IADL were 46.7%. The disability prevalence increased with age, affecting more female than male.
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PMID:Morbidity patterns in aged population in southern Italy. A survey sampling. 1865 37


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