Abstract
STUDY QUESTION
Is the anogenital distance (AGD) correlated to anthropometric, genital and sperm parameters in young adult men?
SUMMARY ANSWER
We observed that reduced AGD is strongly ...associated with altered semen parameters and reduced testicular volume.
WHAT IS KNOWN ALREADY
Abnormalities in the foetal development of the testis have been suggested as causative of common male reproductive disorders, such as cryptorchidism, hypospadias, reduced semen quality and testicular germ cell tumour, collectively defined as 'testicular dysgenesis syndrome'. In human epidemiological studies, alterations in AGD have been frequently associated with clinically relevant outcomes of reproductive health, suggesting AGD as a marker of foetal testicular development.
STUDY DESIGN, SIZE, DURATION
This study was performed within the annual screening protocol to evaluate male reproductive health in the high schools of Padua and surroundings (Veneto Region, the North-East of Italy). Here we report the findings of 794 subjects who completed the study protocol between October 2016 and May 2017.
PARTICIPANTS/MATERIALS, SETTING, METHODS
We evaluated 794 students aged 18-19 years recording the following parameters: height, weight, BMI, waist circumference, arm span, pubis-to-floor and crown-to-pubis length, penile length and circumference, testicular volumes, semen parameters and AGD (measured from the posterior base of the scrotum to the centre of the anus).
MAIN RESULTS AND THE ROLE OF CHANCE
Of the subjects, 49% had an abnormal arm span-height difference (>3 cm) and 63.4% had an altered ratio of crown-to-pubis/pubis-to-floor length (≤0.92). The rate of subjects with reduced testicular volume was 23%. Median sperm concentration was 51.0× 106/ml and total sperm count was 122.5 × 106. AGD showed a direct positive relation with testicular volume and penile length and circumference (R = 0.265, 0.176 and 0.095, respectively, all P < 0.05). No significant relation was observed between AGD and anthropometric parameters. Sperm concentration, total sperm count, progressive motility and normal morphology showed a significant and positive correlation with AGD (R = 0.205, 0.210, 0.216 and 0.117, respectively, all P < 0.05).
LIMITATIONS, REASONS FOR CAUTION
Our cohort of young adults is not representative of the general population. Hormonal evaluation was missing.
WIDER IMPLICATIONS OF THE FINDINGS
Our findings show that AGD is associated with testicular volumes, penile measures and seminal parameters in young adult men. Because AGD is hormonally determined during foetal life, the reported high incidence of reduced semen quality and reduced testicular volume could be related to a reduced androgenic exposure in utero. AGD could represent a simple and useful method to evaluate testicular and penile development in adult men.
STUDY FUNDING/COMPETING INTEREST(S)
The authors have no potential conflict of interest to declare. No external funding was obtained for this study.
TRIAL REGISTRATION NUMBER
N/A.
Many interfering factors may reduce the reliability of waist circumference (WC) measurement in estimating the risk for chronic kidney disease (CKD) associated with obesity. Therefore, we determined ...the independent associations of para- and perirenal ultrasonographic fat thickness with the main markers of kidney function.
A cross-sectional study was performed in 151 type-2 diabetic subjects. Para- and perirenal fat thickness was measured from the inner side of the abdominal musculature to the surface of the kidneys. CKD was defined as eGFR < 60 mL min(-1)1.73 m(-2).
Using both univariate and multivariate regression analyses, eGFR, renal resistance index and uricaemia were best predicted by para- and perirenal fat thickness even when BMI and waist circumference were further added in the statistical model (r(2): 0.366, P = 0.001; r(2): 0.529, P = 0.005; r(2): 0.310, P = 0.026, respectively), whereas waist circumference and BMI did not contribute independently of para- and perirenal fat thickness. Albuminuria was predicted by waist circumference but not by para- and perirenal fat thickness. In subjects with waist circumference above the diagnostic values of metabolic syndrome (48M/59F), eGFR significantly and progressively declined across tertiles of para- and perirenal fat thickness (87.0 ± 27.9 vs 83.5 ± 26.0 vs 62.3 ± 30.6 mL min(-1) 1.73 m(-2), adjusted P < 0.0001) despite comparable waist circumference, and an increasing frequency of CKD was observed across tertiles of subjects with waist circumference both below and above the metabolic syndrome diagnostic values (P < 0.05).
Para- and perirenal fat thickness is an independent predictor of kidney dysfunction in type-2 diabetes explaining an important proportion of the variance of eGFR, renal resistance index and uricaemia.
Abstract
The yearly energy requirements of room temperature (RT) and superconducting (SC) magnet options of a new hadron therapy (HT) facility are compared. Special reference is made to the layouts ...considered for the proposed SEEIIST facility. Benchmarking with the RT CNAO HT centre in Pavia (Italy) was carried out. The energy comparison is centred on the different synchrotron solutions, assuming the same injector and lines in the designs. The beam current is 20 times higher than in present generation facilities: this allows efficient multi-energy extraction (MEE), which shortens the therapy treatment and is needed especially in the SC option, because of the slow magnet ramping time. Hence, power values of the facility in the traditional mode were converted into MEE ones, for a fair comparison between RT and SC magnets. Cryocoolers (c.c.) and a liquefier are also compared, for synchrotron refrigeration. This study shows that a RT facility in MEE mode requires the least average energy, followed by the SC synchrotron solution with a liquefier, while the most energy intensive solution is the SC one with c.c.
Background
Traditional risk factors used to assess cardiovascular risk miss a significant population who are indeed at risk for future cardiac events. Erectile dysfunction (ED) is an emerging marker ...for future cardiovascular disease (CVD) and major adverse cardiovascular events (MACE), especially in young and middle‐aged men with vasculogenic ED. Cavernous arteries morphological alterations at penile colour doppler ultrasound (P‐CDU) are used to find a vasculogenic ED.
Objectives
We investigated the possible relationship between cavernous arteries morphological alterations at P‐CDU assessment and future MACE.
Materials and methods
We conducted a retrospective cohort study involving 300 ED patients, aged 35–65 years (mean age 54.1 ± 7.1), with a follow‐up period of 10 years. Patients underwent vascular evaluation including P‐CDU, colour doppler ultrasound of the carotid and lower limbs arteries. At baseline data for glucose metabolism, lipid profile, hypertension and hormonal status were collected. During the follow‐up period, the occurrence of MACE was evaluated.
Results
We found a strong association between cavernous arteries morphological alterations and CVD with a threefold increased risk of future MACE in comparison to patients with healthy cavernous arteries (RR 3.2, 95% CI 1.17–8.78). This association remained statistically significant after adjustment for CV risk factors (age, glycaemia, total cholesterol, hypertension and smoke).
Conclusions
Morphological alterations of cavernous arteries are independently associated with an increased risk of future MACE. These data contribute to the formulation of the hypothesis that cavernous artery pathology at P‐CDU is related to MACE.
Canted Cosine Theta layout for accelerator magnets is a very attractive since such magnets can be manufactured and assembled without big tooling, and with a relatively modest number of parts and ...tools. In the frame of European Horizon2020 funds, two collaborations, HITRI plus and I.FAST, are developing a CCT design, of 80 mm free bore, 4 T central dipole field, and 0.4 T/s ramp-rate. This magnet is expected to be the bending element of a gantry, to control the beam delivery in therapy with ions (hadrontherapy). The paper illustrates first a comparison between CCT and more classical cosine theta layout, followed by the comparison between Nb-Ti, Nb 3 Sn, MgB 2 , and HTS tapes coils. Relevant requirement for the magnets of this study is to be operated at low current, to limit the heat generation, in sight of a liquid-free cooling system. The results of the comparison is then applied to the design of two magnet demonstrators. Both adopt a low-losses Nb-Ti rope, consistently with the need for keeping the heat generation as low as possible. The first is a straight combined function dipole-quadrupole, while the second is a curved CCT dipole. The paper concludes with the first manufacturing tests for the CCT formers, for which aluminium -bronze, stainless steel and charged PEEK polymer are being explored as basic material.
The Superconducting Ion Gantry (SIG) project is the contribution from INFN (the Italian National Institute for Nuclear Physics) to the international SIGRUM project with the aim of exploring new ...technological solutions for the critical elements of a 430 MeV/u carbon ion gantry. The project includes the design and construction of a cos<inline-formula><tex-math notation="LaTeX">\theta</tex-math></inline-formula> 4 T superconducting dipole demonstrator magnet whose main scope is to prove the feasibility of winding and assembling an accelerator magnet type with a relatively small radius of curvature (1.65 m). In addition to the complexity due to the curvature, the target field ramp rate is 0.4 T/s and the cooling system must not adopt liquid helium. This paper discusses the design activities carried out in the last year on the electromagnetic and thermal domains and reports on the present concepts and infrastructure for the first winding trials.
Abstract Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). Kidney transplantation recipients live longer and have better quality of life than patients on dialysis. ...Hypothalamic gonadal dysfunction in females who have ESRD may be reversed within the first few months after kidney transplantation, such as the ability to have children. Despite thousands of successful pregnancies in transplantation recipients, there is limited information about it. In this study, we evaluated the pregnancy rates and live birth rates in women ( n = 133) who underwent kidney transplantation in our center from 1983 to 2010. Recipients of a second kidney transplantation and recipients of multiorgan transplantations were excluded. We observed 33 pregnancies with 11 live births (33.3%), 12 spontaneous abortions (36.36%), and 10 therapeutic abortions (30.3%). The pregnancy rate was 18%. The live birth rate was 33.3%. Therapeutic abortions were 36.3%, and the pregnancies resulting in fetal loss were 30.3%. The pregnancies were identified in 32 women. The majority of women ( n = 32; 96.9%) had a single pregnancy, whereas 1 woman (3.1%) had two pregnancies. In our series, the pregnancy rates for kidney transplantation recipients were markedly lower and decreased more rapidly than those reported in the general population.
Abstract In Italy, a Continuing Medical Education (CME) program that engages about one million health professionals involved with different roles in National Health Service (physicians, nurses, ...biologists, pharmacologists, psychologists, veterinarians, technicians, etc) became officially mandatory on January 1, 2008. In Italy, the traditional form of acquiring CME credits is to attend lectures and conferences, while the main structured online service was dismissed in November 2008. The Italian Ministry of Health required health professionals to obtain 50 credits/y, with no obligation toward scientific production. In this study, we have preliminarily evaluated the potential impact of a compulsory CME program on the research production of our transplantation center. We selected the research products published by surgeons ( n = 10) and university researchers ( n = 2) who were on duty in our center from 1995 to 2007. For this period, PubMed returned 89 research products with at least one surgeon/researcher of our center as author/coauthor. The mean number of published research products/y was 6.84 ± 4.5. The number of expected research products for 2008 and 2009 on the basis of a time series analysis applied to the period 1995 to 2007 was 12.35 and 12.91, respectively. A search in PubMed restricted to 2008 and 2009 (from January 1 to November 23) returned in both years eight research products. Considering that in our center there was no increase in volume activities or changes in whole working processes, it seems reasonable to assume that the new compulsory, time-consuming Italian CME program may have played a role in the decline of scientific production. A systematic monitoring should be started with the aim to investigate the potential impact of the Italian CME program on biomedical research output, especially for centers and disciplinary areas mainly involved in clinical research.
A collaboration between CERN, CNAO, INFN, and MedAustron has been formed aiming at designing a light rotating gantry suitable for hadron therapy based on 430 MeV/n carbon ion beams. After a first ...design for a 3 T dipole field, as the backbone of the gantry magnetic system, now the collaboration is looking at an alternative design, for at least 4 T field with a faster ramp rate. The magnet is designed according to the cosθ layout to be wound with Nb-Ti superconducting Rutherford cable. One of the main challenges is the very small curvature radius of 1.65 m with a relatively large aperture, of 70-90 mm. Another challenge is the use of indirect cooling despite the cycling operation of 0.4 T/s. The paper reports the preliminary investigation for a 4.5 T dipole. The design will be followed by the construction of a 1 m long demonstrator to be manufactured and tested at INFN (LASA laboratory) in about three years. The conductor is a Rutherford cable of 2.6 µm Nb-Ti filament size, embedded in a Cu-Mn alloy matrix. The resulting gantry is very compact: the collaboration is working on integration between gantry structure and magnets to allow reducing the rotating weight in the range 50-80 tons, which is a factor 4 to 5 less than the present state-of-the-art.
Abstract Encapsulating peritoneal sclerosis (EPS), a severe complication of long-term peritoneal dialysis (PD), produces a 50% mortality rate. EPS is characterized by progressive and excessive ...fibrotic thickening of the peritoneum, leading to encapsulation of the bowel and intestinal obstruction which may present after kidney transplantation (KT), a condition known as posttransplantation EPS. In this study we reviewed 1,500 KT performed in our center from 1982 to 2010, seeking to evaluate the influence of EPS incidence on kidney recipient and graft survival. We detected severe posttransplantation EPS among 16 adult single-kidney cadaveric-donor recipients. The EPS patients (age, 46.68 ± 10.62 years; female/male 5/11) were initially compared with a strictly selected group (n = 48) of non-EPS patients (age, 46.35 ± 10.26 years; female/male, 18/30). Peritoneal dialysis (PD) duration was significantly higher in the EPS group (47.75 ± 9.77 vs. 25.87 ± 10.43 months; P < .0001). This relationship was not only evident on univariate analysis, but also in a multivariate logistic regression model that entered previously selected variables: age ( P = .518), sex ( P = .796), serum creatinine ( P = .441), estimated glomerular filtration rate ( P = .566), and diagnostic category ( P = .804). Diagnostic plots confirmed the reliability of the logistic regression models. In conclusion, EPS which negatively influences the outcome and quality of life of kidney recipients, was related to PD duration before to KT.
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