Type 2 Diabetes and all-cause mortality among Spanish women with breast cancer.

PURPOSE: To explore the effect of type 2 diabetes mellitus (T2DM) on the risk of death among women with breast cancer (BC). METHODS: A survival analysis was conducted among a cohort of women diagnosed with BC between 2006 and 2012 in Spain (n = 4,493). Biopsy or surgery confirmed BC cases were identified through the state population-based cancer registry with information on patients' characteristics and vital status. Physician-diagnosed T2DM was confirmed based on primary health care clinical history. Cox regression analyses were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for all-cause death. Analyses were adjusted for age, hospital size, several clinical characteristics (including BC stage and histology, among others) and treatment modalities. RESULTS: Among the 4,493 BC women, 388 (8.6%) had coexisting T2DM. Overall, 1,299 (28.9%) BC women died during the completion of the follow-up and 785 (17.5%) did so during the first five years after BC diagnosis, resulting in a five-year survival rate of 82.5%. The death rate was higher in women with T2DM (43.8% died during whole period and 26.0% during the first five years) when compared with women without T2DM (27.5% and 16.7%, respectively). Accordingly, all-cause mortality was higher in women with T2DM (aHR: 1.22; 95% CI 1.03-1.44), especially if T2DM was diagnosed before BC (aHR:1.24; 95% CI 1.03-1.50) and in women with BC diagnosed before 50 years (aHR: 2.38; 95% CI 1.04-5.48). CONCLUSIONS: T2DM was associated with higher all-cause mortality among Spanish women with BC, particularly when the T2DM diagnosis was prior to the BC.

Administration of a single dose of a PGF2α analogue (dinoprost) before sexual tests did not improve ram's sexual behaviour.

The aim of this study was to determine if a single administration of dinoprost tromethamine before each test enhances sexual behaviour in inexperienced rams, and if the possible effect is maintained after the rams gain sexual experience. The study was conducted in northeaster Mexico during autumn (breeding season). The study was performed with 26 Saint Croix rams (16.1 ± 1.1 months old). Rams were allocated to two treatments, which were subjected to 15 tests with 2 restrained non-oestrous ewes. While rams from one group (group DIN) received a single dose of dinoprost (10 mg im, Lutalyse, Zoetis) immediately before the test, the other rams remained untreated (group CON). Sexual behaviours were recorded during 5 min. The data were analysed with a mixed model that included the treatment, number of test and their interaction as main effects, and the individual as a random effect. DIN rams displayed less ano-genital sniffings (6.6 ± 0.8 vs 9.7 ± 0.8, P = 0.007), matings (0.11 ± 0.05 vs 0.29 ± 0.05, P = 0.03), and had a lower mating/total mounts ratio (0.05 ± 0.03 vs 0.16 ± 0.03, P = 0.006) than CON rams. There were no other treatment effects, but there were significant effects of time and interactions between treatment and time in all the behaviours. Overall, administration of a single dose of dinoprost before testing did not have positive effects in the development of rams' sexual behaviour, and even, might have negative effects. However, it should be considered that in this study only one prostaglandin analogue, one dose of this analogue, administered immediately before the tests was used, so more studies involving other analogues, doses, and/or regimes of administration should be done.

Functionalized diamond nanothreads from benzene derivatives.

Diamond nanothreads (DNTs) are fully sp3-bonded one-dimensional carbon nanostructures, synthesized recently through compression of crystalline benzene. They possess outstanding mechanical strength, suitable for the development of novel nanostructured reinforced materials. In this article, we use density functional theory calculations to investigate the feasibility and physical properties of functionalized DNTs. We show that the stacking and covalent bonding of benzene derivative molecules (toluene, aniline, phenol and fluorobenzene) may lead to stable configurations analogous to benzene-derived DNTs, with functional groups (-CH3, -NH2, -OH, -F) covalently attached to the surface. The same principle was also applied to pyridine, an aromatic heterocyclic compound, resulting in DNTs containing N heteroatoms within the sp3 C-C chain. We show that the mechanical properties remain practically unaltered compared to the original material, and that the electronic properties can be tuned upon functionalization. The presence of polar functional groups on DNT surfaces are expected to affect their compatibility with other materials and solvents, enabling the development of novel processes and technological applications using DNTs.

Effect of nanoporous membranes thickness in electrochemical biosensing performance: application for the detection of a wound infection biomarker.

Introduction: Nanoporous alumina membranes present a honeycomb-like structure characterized by two main parameters involved in their performance in electrochemical immunosening: pore diameter and pore thickness. Although this first one has been deeply studied, the effect of pore thickness in electrochemical-based nanopore immunosensors has been less taken into consideration. Methods: In this work, the influence of the thickness of nanoporous membranes in the steric blockage is studied for the first time, through the formation of an immunocomplex in their inner walls. Finally, the optimal nanoporous membranes were applied to the detection of catalase, an enzyme related with chronic wound infection and healing. Results: Nanoporous alumina membranes with a fixed pore diameter (60 nm) and variable pore thicknesses (40, 60, 100 µm) have been constructed and evaluated as immunosensing platform for protein detection. Our results show that membranes with a thickness of 40 µm provide a higher sensitivity and lower limit-of-detection (LOD) compared to thicker membranes. This performance is even improved when compared to commercial membranes (with 20 nm pore diameter and 60 µm pore thickness), when applied for human IgG as model analyte. A label-free immunosensor using a monoclonal antibody against anti-catalase was also constructed, allowing the detection of catalase in the range of 50-500 ng/mL and with a LOD of 1.5 ng/mL. The viability of the constructed sensor in real samples was also tested by spiking artificial wound infection solutions, providing recovery values of 110% and 118%. Discussion: The results obtained in this work evidence the key relevance of the nanochannel thickness in the biosensing performance. Such findings will illuminate nanoporous membrane biosensing research, considering thickness as a relevant parameter in electrochemical-based nanoporous membrane sensors.

Chemical and biological profile of the fractionated extract of the species Campylopus savannarum (Müll. Hal.) Mitt.

The indiscriminate use of allopathic drugs has selected resistant bacterial and fungal populations which represents a severe public health problem worldwide. On the other hand, plants are in a prominent position due to the capability to synthesize structurally complex bioactive metabolites that can be an alternative to resistant microorganisms' control. In this work, we evaluated the chemical composition and the antimicrobial, antioxidant, and cytotoxic potential of the fractionated extract of C. savannarum in ethyl acetate. The extract of C. savannarum was divided into 12 fractions that were submitted to phytochemical screening, minimum inhibitory concentration (MIC), reduction of 1,1-diphenyl-2-picrylhydrazine (DPPH), and hemolytic activity of sheep erythrocytes assays. During the investigation, all extract fractions presented alkaloids, triterpenoids, steroids, and phenolic compounds in qualitative analyses, while in the quantitative evaluation, we observed the presence of both phenols and flavonoids in these fractions. Among the fraction, the highest phenolic content was observed in the Cs23-24 fraction (2.480 mg EAG/g), while the Cs31-34 fractions presented the highest amount of flavonoid (182.25 µg EQ/100 mg). Nine of the 12 fractions of the moss species' extract showed antimicrobial action Against Gram-positive bacteria: Bacillus cereus, Staphylococcus aureus, Micrococcus luteus, Bacillus subtilis; Gram-negative bacteria: Pseudomonas aeruginosa; and also antifungal activity against Candida albicans and Candida glabata. The cytotoxic assay demonstrated that the tested fractions did not induce hemolysis at concentrations 10 and 100(µG/ML). In the antioxidant evaluation, the Cs55-69 fractions were the ones that presented the highest scavenging activity (57, 0%) followed by the Cs45-54 fraction (42.7%). Overall, the evaluation of the biological potential of the fractionated extracts of Campylopus savannarum showed promising data, in the search for natural antimicrobial compounds.

Observation of photon-photon thermodynamic processes under negative optical temperature conditions.

Statistical mechanics demands that the temperature of a system is positive provided that its internal energy has no upper bound. Yet if this condition is not met, it is possible to attain negative temperatures for which higher-order energy states are thermodynamically favored. Although negative temperatures have been reported in spin and Bose-Hubbard settings as well as in quantum fluids, the observation of thermodynamic processes in this regime has thus far remained elusive. Here, we demonstrate isentropic expansion-compression and Joule expansion for negative optical temperatures, enabled by purely nonlinear photon-photon interactions in a thermodynamic microcanonical photonic system. Our photonic approach provides a platform for exploring new all-optical thermal engines and could have ramifications in other bosonic systems beyond optics, such as cold atoms and optomechanics.

[Abdominal ultrasonography versus abdominal CT in the follow-up of testicular germ cell tumors]. / Comparación de la ecografía abdominal con la tomografía computarizada abdominal en el seguimiento del tumor de células germinales testicular.

INTRODUCTION: Testicular germ cell tumors are common in young men. There is a wide consensus regarding the key points in their diagnosis and treatment, although some elements, including the best approach to follow-up, are being reviewed and revised. We present a statistical study that uses tools for the evaluation of diagnostic tests to compare the usefulness of abdominal ultrasonography (US) in comparison with that of abdominal CT, taken as the gold standard, in the detection of liver metastases and retroperitoneal adenopathies in patients with testicular germ cell tumors. MATERIAL AND METHODS: We analyzed a total of 308 diagnostic tests (154 CT studies and 154 US studies) from 59 patients with at least one year's follow-up at our institution. Patients underwent abdominal US before abdominal CT following a standard protocol. RESULTS: Compared to the gold standard, abdominal US had 95% sensitivity, 92% specificity, 82% PPV, and 98% NPV. CONCLUSION: US is very sensitive and can be used in protocols for the follow-up of primary testicular tumors to rule out disease.

Quantitative evaluation of the effects of subthalamic stimulation on gait in Parkinson's disease patients using principal component analysis.

BACKGROUND: Principal component analysis (PCA) was applied to the ground reaction force (GRF) for evaluating the deep brain stimulation of the subthalamic nucleus (DBS-STN) effects in Parkinson's disease (PD) subjects with and without medication. METHODS: Ten subjects who underwent DBS-STN were evaluated under the following four conditions: without treatment (mof-sof), with stimulation (mof-son), with medication (mon-sof), and with both treatments (mon-son). A control group of 30 subjects was also evaluated. PCA was applied separately on each GRF component. Broken stick criterion selected eight principal components (PC) from vertical GRF and one from each horizontal GRF. A standard distance was calculated using these 10 PCs and the gait speed to measure how far the PD group's gait was from the normal pattern. RESULTS: The standard distance allowed classifying normal and PD subjects in the mof-sof condition with 100% accuracy, sensitivity, and specificity. The same distance was calculated for mon-sof, mof-son, and mon-son conditions. The smallest mean standard distance was found in the mon-son condition, which was significantly different from mof-sof (Friedman test with Dunn post-hoc, p < .05). CONCLUSION: PCA allowed the quantitative evaluation of treatment effects, indicating that DBS-STN improves the GRF pattern in PD subjects, primarily in the medication on state.

[Correlates of potassium transport during peritoneal equilibration tests using different dialysate glucose concentrations]. / Análisis del transporte peritoneal de potasio mediante pruebas de equilibrio peritoneal con diferentes concentraciones de glucosa.

BACKGROUND: there are gaps in the knowledge of factors which influence peritoneal potassium transport in Peritoneal Dialysis (PD). The aims of this study were to compare peritoneal potassium transport in PD patients undergoing 2.27% and 3.86% peritoneal equilibration tests (PET), and to disclose clinical correlates of this phenomenon. METHOD: ninety PD patients underwent 2.27% and 3.86% PET, in a random order. We compared peritoneal potassium transport in both tests, and searched for correlations between D/P potassium at 240 minutes (main study variable) and PET-derived markers of peritoneal function and selected demographic, clinical and biochemical variables, using a multivariate approach. MAIN RESULTS: D/P potassium showed a good agreement between both PET, and presented a univariate association with creatinine transport, but not with plasma potassium, ultrafiltration or sodium dip. Age, PD modality, peritoneal glucose load, icodextrin, ACEI-ARA and calcium antagonist therapy, urinary potassium and glomerular filtration rate were other univariate correlates of potassium transport. Multivariate analysis confirmed D/P creatinine at 240 minutes (B=0.40 [95% CI 0.26-0.53] 2.27%, B=0.36 [0.21-0.51] 3.86%, p < 0.0005) as the main predictor of D/P potassium at 240 minutes. Urinary potassium, rather than glomerular filtration rate, sustained also an inverse correlation with the dependent variable. Treatment with ACEI-ARA was consistently associated with peritoneal potassium transport (3.86% PET B=0.08 [0.04-0.12], p < 0.0005). CONCLUSIONS: The 2.27% and the 3.86% PET show a good agreement at the time of estimating peritoneal potassium transport. Urinary potassium excretion and treatment with ACEI-ARA (3.86% test) show an independent association with peritoneal potassium transport rates.

Application of principal component analysis in vertical ground reaction force to discriminate normal and abnormal gait.

Discrete parameters from ground reaction force (GRF) are been considered in gait analysis studies. However, principal component analysis (PCA) may provide additional insight into gait analysis for considering the complete pattern of GRF. This study aimed at testing the application of PCA to discriminate the vertical GRF pattern between control group (CG) and patients with lower limb fractures (FG), as well as proposing a score to quantify the abnormality of gait. Thirty-eight healthy subjects participated of CG and 13 subjects in FG, five subjects from FG were also evaluated after physiotherapeutic treatment (FGA). The GRF was measured by an instrumented treadmill. Principal component coefficients (PCCs) were obtained by singular value decomposition using GRF of complete stride. Two, four and six PCCs were used to obtain the standard distance (D). The classification between groups was mainly given by the first PC, which indicated higher loading factors during push off of affected side and heel strike of unaffected side. The classification performance achieved 92.2% accuracy with two PCCs, 94.1% with four PCCs and 96.1% with six PCCs. Four subjects reached normal boundary after treatment, with all FGA subjects presenting decreased D. This study demonstrates that PCA is an adequate method for discriminating normal and abnormal gait and D allows an objective evaluation of the progress and effectiveness of rehabilitation treatment.

A direct route to activated two-dimensional cobalt oxide nanosheets for electrochemical energy storage, catalytic and environmental applications.

Two-dimensional Co3O4 nanosheets have emerged as attractive materials for use in a number of relevant technological applications. To exhibit a competitive performance in such uses, however, their structure needs to be activated, which is frequently accomplished via post-synthesis reduction strategies that introduce oxygen vacancies and increase the number of active Co(II) sites. Here, we investigate a direct route for the synthesis of activated Co3O4 nanosheets that avoids reduction post-treatments, yielding materials with a high potential towards energy- and environment-related applications. The synthesis relied on an interim amorphous cobalt oxide material with nanosheet morphology, which upon calcination afforded Co3O4 nanosheets having Co(II) sites in quantities similar to those usually found for Co3O4 nanostructures activated by reduction post-treatments. When tested as electrodes for charge storage, the nanosheets demonstrated a competitive behavior in terms of both capacity and rate capability, e.g., a gravimetric capacity of ∼293 mAh g-1 at 1 A g-1 with 57% retention at 60 A g-1 was measured for nanosheets calcined at 350 °C. The materials were shown to be efficient catalysts for the reduction of nitroarenes (4-nitrophenol and 4-nitroaniline), outperforming other Co3O4 nanostructures, as well as effective adsorbents for the removal of organic dyes (methyl orange, methylene blue) from water.

Predicted change in the number of permanent medical teachers from 2017 to 2026. The training of future physicians in critical condition. / Evolución previsible en el número de profesores permanentes de Medicina del 2017 al 2026. La formación de los futuros médicos en situación crítica.

The significant and progressive reduction in the number of permanent teachers in medical schools (professor, associate professor and assistant professor) is a reason for concern for the National Conference of Deans. This reduction will intensify in the coming decade (2017-2026). Forty-three percent of the permanent faculty will retire, as will 55% of the faculty linked to clinical areas, 34% of the faculty not linked to clinical areas and 32% of the faculty of basic areas. This deficit is significant now, and, in a few years, the situation will be unsustainable, especially in the clinical areas. This report reveals the pressing need to adopt urgent measures to alleviate the present situation and prevent a greater problem. The training of future physicians, immediately responsible for the health of our society, depends largely on the theoretical and practical training taught in medical schools, with the essential collaboration of healthcare institutions. Paradoxically, while the number of teachers decreases substantially, there is an exponential increase in the number of medical schools and students who are admitted every year without academic or healthcare justification.

Synthesis of multi-walled carbon nanotubes by spray-pyrolysis using a new iron organometallic complex as catalytic agent.

An organometallic catalytic agent ([(Hexyl)4N]3FeCl3Br3) has been synthesized through the reaction of tetrahexylammonium bromide ((Hexyl)4NBr) and iron chloride (FeCl3) aqueous solutions. Multi-walled carbon nanotubes (MWCNTs) were obtained by spray pyrolysis of toluene (carbon source) using the new organometallic compound as catalyst. The synthesized catalytic agent was characterized by ultraviolet-visible spectroscopy (UV-Vis), Fourier transform infrared spectroscopy (FTIR), and thermal analysis (TA) techniques. Spectroscopic results indicated that the new iron organometallic compound has suitable characteristics to grow MWCNTs by spray pyrolysis. The MWCNTs were analyzed by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD) techniques. The MWCNTs grow in a disordered way without orientation with diameters ranging from 20 to 50 nanometers. XRD patterns exhibit the 2-H graphite characteristics peaks of the MWCNTs.

Simplified route to multi-walled carbon nanotube synthesis by aerosol assisted chemical vapor deposition.

Uniform multi-walled carbon nanotubes (MWCNTs) were obtained decomposing toluene inside of fused silica tubing previously covered with Co oxide thin film. The two-step process, ruled successively in the same aerosol assisted chemical vapor deposition (AACVD) set up, constitutes a simplified route to the synthesis of MWCNTs. First, Co oxide thin film was deposited inside of fused silica tubing at 723 K, using a precursor solution of Co acetate in absolute methanol. After Co oxide deposition, the covered tubing was heated up to 1173 K under Ar flow, then a mist of toluene was injected inside the tubing, using also Ar as carrier gas, consequently MWCNTs were obtained in the internal wall of the tubing. The Co oxide film and the MWCNTs were analyzed by scanning electron microscopy (SEM), high resolution transmission electron microscopy (HRTEM) and atomic force microscopy (AFM). Uniform and very long MWCNTs (several tens of microm) with diameters around 20 to 100 nm were observed, with the advantage that the content of Co particles inside the nanotube was very low.

Slow and ultra-rapid freezing protocols for cryopreserving mouflon (Ovis musimon) and fallow deer (Dama dama) epididymal sperm.

This study examines the effectiveness of two methods for cryopreserving post-mortem epididymal sperm - conventional slow freezing employing a short equilibration time with glycerol, and ultra-rapid freezing - from the wild ruminant species Ovis musimon (mouflon) and Dama dama (fallow deer). A Tris-citric acid-glucose (TCG) + 12% egg yolk-based medium was used for the conventional slow freezing of the fallow deer sperm, whereas a Tes-Tris-glucose (TEST) + 6% egg yolk-based medium was used for the mouflon sperm. Glycerol was added to a final concentration of 5% to both media. The same diluents were used for ultra-rapid freezing but replacing the glycerol with 100 mM of sucrose. Sperm variables (motility, viability, acrosome integrity, membrane integrity, and morphological abnormalities) were analyzed before and after cryopreservation. Although values were generally better after the thawing of the conventionally cryopreserved sperm, total sperm motility (38.40 ±â€¯4.44% in mouflon and 31.25 ±â€¯3.37% in fallow deer) and total live sperm (47.19 ±â€¯5.18% in mouflon and 43.13 ±â€¯2.43% in fallow deer) were acceptable for the ultra-rapidly cooled sperm. Independent of the cryopreservation method, membrane integrity, acrosome integrity and the percentages of dead sperm and sperms with a damaged acrosome were better for the cryopreserved mouflon sperm than the fallow deer sperm (P < 0.05). Despite exerting a more harmful effect on sperm variables than conventional freezing, ultra-rapid freezing may be a useful alternative for the cryopreservation of these species' epididymal sperm in the field, as this simple technique does not require sophisticated equipment and expertise.

Shock attenuation characteristics of three different military boots during gait.

Musculoskeletal injuries are related to the cushioning properties of boots in military populations. This study aimed to compare ground reaction force (GRF) and subjective perceived comfort from two different military boots supplied by the Brazilian Army with a commercial boot. Twenty army recruits volunteered for a GRF assessment during walking on a 10-m walkway and a perceived comfort test after 20min walking on a treadmill. Both experiments were conducted with three different military boots: CC10 (styrene-butadiene rubber - SBR - midsole 30mm thickness, 65 Shore A; 631.8g weight; supplied by the Brazilian Army); CC13 (SBR midsole 20.6mm thickness, 66 Shore A; 530.3g weight; supplied by the Brazilian Army) and CAT (polyurethane - PU - midsole 31.7mm thickness, 55 Shore A; 423g weight; commercially available). GRF was analyzed in the time (principal component analysis - PCA) and frequency (Blackman-Tukey) domains. No difference was found for the first and second peak forces or loading rate; however, significant influence from the military boots' design on GRF was found by PCA and frequency analysis. Loading factor presented higher values at early stance with lower force for CC10 compared to CC13 at these epochs. CC13 also presented higher power spectral density compared to CC10 at higher frequency bands. However, CAT was significantly more comfortable than CC10. These results suggest that the thicker SBR midsole boot was more effective in reducing impact, while the lightest boot with softer midsole hardness made with PU was the most comfortable.

Effects of clarithromycin, azithromycin and rifampicin on terbutaline-induced sweating in foals.

BACKGROUND: Erythromycin (ERY) induces anhidrosis in foals. Azithromycin (AZI) and clarithromycin (CLA), often combined with rifampicin (RIF), are commonly used to treat Rhodococcus equi infections, but effects on sweating have not been investigated. OBJECTIVE: To determine the effects of AZI, CLA and RIF on sweat responses in normal foals. STUDY DESIGN: Each experiment was a blinded, duplicated, six foal × three period counterbalanced within subjects design (12 foals/experiment). METHODS: Antimicrobials were given orally for 5 days. In Experiment 1, ERY, AZI and CLA were given. In Experiment 2, ERY, RIF and ERY/RIF combination were used. Quantitative intradermal terbutaline sweat tests were performed daily for 3 days before and 1, 2, 5, 9, 24, and 39 days after treatment. Data were analysed by repeated measures analysis of variance procedures. Significance was P≤0.05. RESULTS: In Experiment 1, all macrolides suppressed sweating although CLA and AZI were less potent than ERY. In Experiment 2, significant sweat suppression occurred in foals given ERY with or without RIF, but there was no effect of RIF alone. Rifampicin reduced sweat suppression by ERY on Day 1 of treatment but not thereafter. MAIN LIMITATIONS: Because ERY blood concentrations were not measured, effects of RIF on ERY-induced anhidrosis could not definitively be ascribed to altered ERY bioavailability. CONCLUSIONS: All macrolides commonly used to treat R. equi pneumonia, i.e. ERY, AZI and CLA, induce anhidrosis in foals. The potent anti-sudorific effect of ERY is delayed, but not substantially affected by concurrent RIF administration.

Erectile dysfunction and HTLV-I infection: a silent problem.

The human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with a chronic myelopathy known as HTLV-I-Associated Myelopathy or Tropical Spastic Paraparesis (HAM/TSP). The main objective was to assess the frequency of erectile dysfunction (ED) in HTLV-I-infected individuals from Salvador and other cities from Bahia, Brazil, as well as to verify if sexual dysfunction correlates with urinary symptoms and overall neurological impairment. From January 2001 to April 2004, 218 HTLV-I carriers (111 male and 107 female subjects) had complete clinical, neurological, and urological evaluation. They were assessed using standardized questionnaires to determine urinary complaints (Urinary Distress Inventory) and ED (Brief Male Sexual Function Inventory). Neurological impairment was established by Expanded Disability Status Scale (EDSS) from 0 to 10. HAM/TSP was considered as EDSS> or =2. A total of 17 males had clinically defined HAM/TSP (group 1). From the 94 HTLV-I-infected males, 62 were selected (group 2) and paired by age with patients in group 1. A total of 79 individuals were selected for this study. The age ranged from 35 to 81 y (mean=47.9+/-9.65). The percentage of ED in the studied population was 40.5%. In the HAM/TSP group, ED frequency was 88.2%. The associations among sexual dissatisfaction, erectile dysfunction, urinary symptoms (frequency, nocturia, and urgency) and EDSS> or =2 were statistically significant. In HAM/TSP, there is a slow and progressive degeneration of the lateral funiculus of the spinal cord. HTLV-I-infected individuals present a high frequency of ED and it is closely associated to urinary symptoms and the overall neurological picture. The HTLV-I carriers already had prominent compromise of the sexual activity.