Summary
Concern regarding adverse effects of finasteride is increasing. We aimed to determine the type and frequency of symptoms in men having long‐term sexual and non‐sexual side effects after ...finasteride treatment (a condition recently called post‐finasteride syndrome, PFS) against androgenetic alopecia (AGA). Subjects were recruited at the Urology Unit of the Trieste University‐Hospital, and from a dedicated website. Out of 79 participants, 34% were white Italians, mean age was 33.4 ± 7.60 years, mean duration of finasteride use was 27.3 ± 33.21 months; mean time from finasteride discontinuation was 44.1 ± 34.20 months. Symptoms were investigated by an ad hoc 100 questions' questionnaire, and by validated Arizona Sexual Experience Scale (ASEX) and Aging Male Symptom Scale (AMS) questionnaires. By ASEX questionnaire, 40.5% of participants declared getting and keeping erection very difficult, and 3.8% never achieved; reaching orgasm was declared very difficult by 16.5%, and never achieved by 2.5%. By the ad hoc questionnaire, the most frequent sexual symptoms referred were loss of penis sensitivity (87.3%), decreased ejaculatory force (82.3%), and low penile temperature (78.5%). The most frequent non‐sexual symptoms were reduced feeling of life pleasure or emotions (anhedonia) (75.9%); lack of mental concentration (72.2%), and loss of muscle tone/mass (51.9%). We contributed to inform about symptoms of PFS patients; unexpectedly loss of penis sensitivity was more frequent than severe erectile dysfunction and loss of muscle tone/mass was affecting half of the subjects. Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post‐finasteride syndrome.
Patients with diabetes are recommended to self-monitor their blood glucose levels also at home. Accuracy of a hand-held glucometer and a Continuous Glucose Monitoring (CGM) device were comparatively ...evaluated.
Venous blood samples (for reference laboratory determinations; n=428) were collected from 18 type 1 patients (35–65years old), immediately followed by capillary measurement (Bayer ContourLink meter) and CGM readings (Medtronic Paradigm).
Laboratory values did not differ statistically from ContourLink and CGM readings, mean difference (±SD) being −0.05±1.06mmol/L and 0.10±1.84mmol/L glucose, respectively. A bias ((value−reference)/reference×100) ≥15% was observed in 27.7% and 54.9% of cases, respectively. Notably, below 3.9mmol/L glucose (hypoglycemic threshold), an absolute error>0.8mmol/L was found in 78.9% and 94.1% of cases. The absolute errors of the CGM device were inversely related to the rate of glucose change (r=0.598, p<0.001).
A very large error was observed at the extreme glycemic values, which may lead to erroneous therapy. Consequently, performance of future portable glucometers should be focused in particular under hypo- and hyper-glycemia. Moreover, integrated CGM devices should not disregard the effect of the rate of blood glucose change on the sensor readings.
► Accuracy of a hand-held glucometer and a continuous monitoring device was evaluated. ► Overall, laboratory values did not differ from glucometer and CGM readings. ► Below the hypoglycemic threshold the error was >0.8mM in 78.9% and 94.1% of cases. ► The errors of the CGM device were inversely related to the rate of glucose change. ► Future portable meters performance should be focused on the extreme glucose levels.
Vaginal innate immunity in response to microbial perturbation is still poorly understood and could be crucial for protection from adverse outcomes. We investigated the relationship between ...interleukin (IL)‐8, IL‐1β and neutrophils in vaginal fluid obtained from 60 healthy women and 51 women who were bacterial vaginosis (BV) positive. Concentrations of IL‐8 and IL‐1β were highly correlated with counts of neutrophils in vaginal fluid of the entire population examined (111 subjects). Vaginal IL‐1β concentrations were significantly higher (P < 0.001) in BV positive women. There was no significant difference in IL‐8 levels or number of neutrophils between healthy controls and BV positive women. None of the healthy controls with high neutrophil counts (≥75th percentile, 14 average count per field) had high concentrations of IL‐1β (≥75th percentile, 220 pg/ml), whereas 84% of BV positive women with high neutrophil counts had high IL‐1β concentrations (P < 0.001). On the contrary, no difference in the percentage of subjects with elevated concentrations of IL‐8 (≥75th percentile, 2842 pg/ml) was found between healthy and BV positive women with high numbers of neutrophils (55.5% of healthy versus 53% of BV positive women). Our findings show that BV causes a large increase in IL‐1β concentrations which is not paralleled by an increase in IL‐8 concentrations in vaginal fluid, suggesting that BV‐associated factors more specifically dampen IL‐8 rather than IL‐1β. The lack of an increase in IL‐8 may explain the absence of an increase in neutrophil numbers in most women exposed to abnormal vaginal colonization (BV).
Hematological assessment is crucial in athletes: the risk of sports' anemia should be monitored with hematological parameters and iron metabolism tests. The aim of this study was to evaluate soluble ...transferrin receptor (sTfR) efficacy, as it is highly sensitive and specific and usually utilized in sport medicine for monitoring iron metabolism.
sTfR was studied using two immunological methods (IDeA Orion, and Biokit) on a group of professional athletes, together with hematological and iron metabolism parameters. Values have been compared with those of sedentary people, before and during competitive season. Athletes were 76 professional male soccer players plus 20 males and 14 females of the alpine ski Italian National Teams.
The sTfR values in athletes are similar to those found in sedentary people. Different results have been observed between the two different methods: a bias of 0.37 mg/L was found comparing them. A significant correlation between sTfR and iron, transferrin saturation, and reticulocytes was found in skiers; there was no correlation with hemoglobin, erythrocytes, ferritin. In soccer players significant differences have been retrieved among different teams' distribution of data.
The principal limit for using sTfR in sports medicine, but also in the general population, is the lack of standardization among methods. The quantitative differences in athletes between the two methods are high, although the behavior of the parameter is similar from the quality point of view. The differences between measured concentrations could influence the thresholds used in antidoping context.
Objective: The aim of this study was to investigate the correlation between the immunoglobulin A immune response to
Gardnerella vaginalis hemolysin and sialidase activity in vaginal fluids from ...patients with bacterial vaginosis.
Study Design: Nonpregnant women who were examined at a gynecologic clinic, in an age range of 18 to 62 years, were enrolled. The study population comprised 131 healthy volunteers, 32 women with bacterial vaginosis that was positive for immunoglobulin A to
Gardnerella vaginalis hemolysin, 40 women with bacterial vaginosis that was negative for immunoglobulin A to
Gardnerella vaginalis hemolysin, and 19 women with
Candida vaginitis. Bacterial vaginosis was diagnosed by clinical criteria and Gram stain.
Results: Sialidase activity was present in 75% (54/72) of patients with bacterial vaginosis. Women having bacterial vaginosis and lacking a specific immunoglobulin A response had a significantly higher level of sialidase activity than patients who had an immune response against
Gardnerella vaginalis hemolysin. Sialidase activity was detected in 87% (35/40) of the former subgroup of patients with bacterial vaginosis and in 59% (19/32) of women of the latter subgroup. No sialidase activity was measured in patients with candidiasis. Specificity of the assay for healthy controls was 95% (124/131 women without sialidase activity).
Conclusions: Sialidases produced by
Prevotella bivia and other microorganisms present in the microflora of patients with bacterial vaginosis are very likely a virulence factor not only by destroying the mucins and enhancing adherence of bacteria but also by impairing a specific immunoglobulin A immune response against other virulence factors such as cytotoxin from
Gardnerella vaginalis. (Am J Obstet Gynecol 1998;178:511-5.)
The molecular basis for the DNA binding specificity of the thyroid transcription factor 1 homeodomain (TTF- 1HD) has been investigated. Methylation and ethylation interference experiments show that ...the TTF-1HO alone recapitulates the DNA binding properties of the entire protein. Studies carried out with mutant derivatives of TTF-1HD indicate a precise correspondence of some of its amino acid residues with specific bases in its binding site, allowing a crude orientation of the TTF- 1HD within the protein - DNA complex. TTF-1HD shows an overall geometry of interaction with DNA similar to that previously observed for Antennapedia class HDs, even though the binding specificities of these two types of HDs are distinct. We demonstrate that the crucial difference between the binding sites of Antennapedia class and TTF-1 HDs is in the motifs 5′-TAAT-3′, recognized by Antennapedia, and 5′-CAAG-3′, preferentially bound by TTF-1. Furthermore, the binding of wild type and mutants TTF-1 HD to oligonucleotides containing either 5′-TAAT-3′ or 5′-CAAG-3′ indicate that only in the presence of the latter motif the Gln50 in TTF-1 HD is utilized for DNA recognition. Since the Gin at position 50 is an essential determinant for DNA binding specificity for several other HDs that bind to 5′-TAAT-3′ containing sequences, we suggest that utilization by different HDs of key residues may depend on the sequence context and probably follows a precise hierarchy of contacts.
The purpose of this study was to assess if easy to measure vaginal fluid biomarkers are predictive for low birth weight (LBW, <2500 g), very LBW (VLBW, <1500 g), spontaneous preterm at <37 weeks' ...gestation, and total preterm deliveries (at <37, <35, <32 weeks' gestation).
Low and high cutoffs for vaginal fluid pH, sialidase, and prolidase activities were examined in a nested case-control study of 579 Danish women (from a study population of 2846 women) with samples collected at mean 17 weeks' gestation. One hundred sixteen LBW (17 VLBW), 117 preterm deliveries (85 spontaneous), and 418 normal term deliveries were analyzed.
Vaginal pH ≥4.7 or pH ≥5 by itself was not associated with LBW or prematurity. Conversely, combination of pH ≥5 and high sialidase activity demonstrated OR 17 (CI 1.8-150) for LBW; OR 31 (CI 1.8-516) for VLBW; along with OR 18 (CI 1.6-204) for preterm at <35 weeks'; and OR 31 (CI 1.9-542) for preterm at <32 weeks' gestation. The combination of pH ≥5 and high prolidase activity demonstrated OR 13 (CI 1.3-122) for LBW; OR 33 (CI 2.0-553) for VLBW, as well as OR 9.2 (CI 0.6-150) for preterm at <35 weeks'; and OR 35 (CI 2.0-586) for preterm at <32 weeks' gestation. In this population, no woman having high sialidase and high prolidase activity had a term birth, or a baby weighting ≥2500 g at birth.
In this Danish population, mid-gestation findings of vaginal fluid elevated pH with sialidase and/or prolidase were associated with LBW, VLBW, and early preterm at <35 or <32 weeks' gestation.
OBJECTIVE: Our goal was to study the mucosal host response in bacterial vaginosis by evaluating the presence of a specific immune response elicited against the
Gardnerella vaginalis hemolysin in ...vaginal fluids of patients and by verifying its correlation with usual criteria adopted to diagnose bacterial vaginosis.
STUDY DESIGN: A total of 123 white women attending the gynecologic care unit for urogenital complaints or for screening of uterine malignancies (Papanicolaou test) aged from 20 to 60 years, nonmenstruating, were enrolled. Bacterial vaginosis was diagnosed by clinical criteria and a Gram stain score >6.
RESULTS: We performed the determination of the antibody response in vaginal fluid against the hemolysin produced by
G. vaginalis, a common agent present in bacterial vaginosis. The purified
G. vaginalis toxin was a suitable antigen for detecting the presence of an immune response in the vaginal fluids of patients with bacterial vaginosis regardless of the strain of
G. vaginalis present. A specific immunoglobulin A response was detected in 60% of women with overt bacterial vaginosis (Gram stain score >6) and in 18.5% of women with intermediate vaginal flora (Gram stain score 4 to 6). The specificity of the test was 91%.
CONCLUSIONS: We found a correlation between the specific local immune response to
G. vaginalis toxin and bacterial vaginosis. The highly purified form of the toxin is able to discriminate disorders from the opportunistic colonization by
G. vaginalis. (Am J Obstet Gynecol 1996;175:1601-5.)
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