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BACKGROUND: Both macroscopic and histological lesions are frequently detected at upper endoscopy in elderly patients. We assessed the prevalence of main endoscopic and histological alterations in elderly (> 65 years old) patients. METHODS: In this study, clinical, endoscopic and histological features of patients referred for upper endoscopy in clinical practice were retrieved. Both univariate and multivariate analyses were executed. Comparisons with previous data were performed. RESULTS: A total of 1336 underwent upper endoscopy in the 28 participating centres. At endoscopy, at least one macroscopic lesion was present in overall 420 (31.4%) patients. Erosive gastritis (13.3%) and erosive oesophagitis (9.8%) were the most prevalent lesions, whilst Barrett's oesophagus, gastric ulcer, duodenal ulcer and erosive duodenitis were observed in 1.8%, 2%, 1.4% and 3.1% patients, respectively. Nine (0.6%) cases of oesophageal, 25 (1.8%) gastric and 2 (0.1%) duodenal neoplasia were detected. At histology, Helicobacter pylori infection was diagnosed in 99 (15.9%) patients, and extensive precancerous lesions on gastric mucosa were detected in 80 (14.5%) patients. Endoscopic lesions were more frequent in males, at first endoscopy and in those with alarm symptoms and lower during PPI therapy. At multivariate analysis, PPI therapy significantly reduced the probability of finding endoscopic lesions (OR: 0.68, 95% CI: 0.46-0.99; P = 0.04), whilst neoplastic lesions were associated with presence of alarm symptoms (OR: 1.5, 95% CI: 1.1-2.1; P = 0.005). CONCLUSIONS: We found that the frequency of erosive and neoplastic lesions remained high in elderly patients, whilst the prevalence of both H. pylori infection and peptic ulcer was decreased.
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(1) Background: Lifestyle changes, eventually coupled with a nutraceutical, are recommended strategies for managing high-normal blood pressure (BP) patients with low-moderate cardiovascular (CV) risk. In a real-life clinical setting, we evaluated the effects of generic written lifestyle advice, extrapolated from the 2018 ESC/ESH guidelines, and a beetroot-based nutraceutical on 24 h BP in a population with a high-normal office BP and low-moderate CV risk. (2) Methods: A longitudinal observational study was conducted in two ESH Hypertension Excellence Centres on 43 consecutive subjects with high-normal BP according to repeated office BP (OBP) measurements and a low-moderate CV risk based on SCORE2/SCORE2-OP. Additionally, 24 h ambulatory BP monitoring (ABPM) was carried out at baseline and three months after lifestyle changes, according to generic written advice from the 2018 ESC/ESH guidelines, coupled with a nutraceutical containing 500 mg of dry beetroot extract. (3) Results: The mean age was 50 ± 11 years, with male prevalence (54%). The prevalence of overweight/obesity was 58%. The mean OBP was 135 ± 3/85 ± 3 mmHg. At baseline, the mean 24 h BP, daytime BP, and night-time BP were 127 ± 7/80 ± 6 mmHg, 131 ± 8/83 ± 6 mmHg, and 118 ± 8/70 ± 5 mmHg, respectively, BP profiles compatible with hypertension status in some subjects. After a median follow-up of 98 (92-121) days, all BPs, except night-time diastolic BP, were significantly decreased: -3 ± 6/-2 ± 4 mmHg for 24 h BP, -3.9 ± 6.0/-3.0 ± 4.0 mmHg for daytime BP, and -3.3 ± 7.4/-1.3 ± 4.7 mmHg for night-time BP, respectively. No significant clinical changes in body weight were detected. BP decreased independently of baseline BP levels, sex, smoking status, and body mass index, while a more substantial BP decrease was observed in older patients. (4) Conclusions: Our exploratory study shows, for the first time, that written generic lifestyle advice taken from the ESC/ESH hypertension guidelines coupled with a beetroot-based nutraceutical may represent a valid initial non-pharmacological approach in subjects with a high-normal office BP and low-moderate CV risk, even without personalized diet interventions.
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Doenças Cardiovasculares , Hipertensão , Humanos , Masculino , Idoso , Adulto , Pessoa de Meia-Idade , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco , Hipertensão/epidemiologia , Monitorização Ambulatorial da Pressão Arterial , Suplementos Nutricionais , Fatores de Risco de Doenças Cardíacas , Estilo de VidaRESUMO
BACKGROUND AND AIMS: International guidelines advise improving esophagogastroduodenoscopy (EGD) quality in Western countries, where gastric cancer is still diagnosed in advanced stages. This nationwide study investigated some indicators for the quality of EGD performed in endoscopic centers in Italy. METHODS: Clinical, endoscopic, and procedural data of consecutive EGDs performed in one month in the participating centers were reviewed and collected in a specific database. Some quality indicators before and during endoscopic procedures were evaluated. RESULTS: A total of 3,219 EGDs performed by 172 endoscopists in 28 centers were reviewed. Data found that some relevant information (family history for GI cancer, smoking habit, use of proton pump inhibitors) were not collected before endoscopy in 58.5-80.7% of patients. Pre-endoscopic preparation for gastric cleaning was routinely performed in only 2 (7.1%) centers. Regarding the procedure, sedation was not performed in 17.6% of patients, and virtual chromoendoscopy was frequently (>75%) used in only one (3.6%) center. An adequate sampling of the gastric mucosa (i.e., antral and gastric body specimens) was heterogeneously performed, and it was routinely performed only by 23% of endoscopists, and in 14.3% centers. CONCLUSIONS: Our analysis showed that the quality of EGD performed in clinical practice in Italy deserves to be urgently improved in different aspects.
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Neoplasias Gastrointestinais , Neoplasias Gástricas , Humanos , Endoscopia do Sistema Digestório/métodos , Endoscopia Gastrointestinal , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia , ItáliaRESUMO
The role of oxidative stress (OS) in male infertility as a primary etiology and/or concomitant cause in other situations, such as inflammation, varicocele and gonadotoxin effects, is well documented. While reactive oxygen species (ROS) are implicated in many important roles, from spermatogenesis to fertilization, epigenetic mechanisms which are transmissible to offspring have also recently been described. The present review is focused on the dual aspects of ROS, which are regulated by a delicate equilibrium with antioxidants due to the special frailty of spermatozoa, in continuum from physiological condition to OS. When the ROS production is excessive, OS ensues and is amplified by a chain of events leading to damage of lipids, proteins and DNA, ultimately causing infertility and/or precocious pregnancy termination. After a description of positive ROS actions and of vulnerability of spermatozoa due to specific maturative and structural characteristics, we linger on the total antioxidant capacity (TAC) of seminal plasma, which is a measure of non-enzymatic non-proteic antioxidants, due to its importance as a biomarker of the redox status of semen; the therapeutic implications of these mechanism play a key role in the personalized approach to male infertility.
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Infertilidade Masculina , Oxidantes , Feminino , Masculino , Humanos , Gravidez , Espécies Reativas de Oxigênio/metabolismo , Oxidantes/farmacologia , Antioxidantes/farmacologia , Fertilidade/fisiologia , Estresse Oxidativo , Infertilidade Masculina/metabolismo , Espermatozoides/metabolismo , Sêmen/metabolismoRESUMO
OBJECTIVES: To evaluate the agreement between pleural malignant mesothelioma diagnosis in life, with diagnoses confirmed at autopsy, and the certification of the cause of death in the form of the Italian National Institute of Statistics (Istat). DESIGN: comparison between autopsic cases and cases from Istat. SETTING AND PARTICIPANTS: two series of autopsy diagnoses of pleural malignant mesothelioma placed from 1997 to 2016; 185 in shipyard workers and 90 in Brescia province inhabitants, for whom the Istat death form was acquired for 180 and 89 subjects, respectively. RESULTS: the general agreement between pleural malignant mesothelioma clinical diagnosis in life and death certification was about 91% for the first group and 92% for the second one. In the first group, the age at diagnosis does not affect the accuracy of the death certification, which instead increased over time to become total in the period 2010-2016. CONCLUSIONS: the study suggests that the agreement between pleural malignant mesothelioma clinical diagnosis and certification of the cause of death appears to be very high.
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Atestado de Óbito , Mesotelioma Maligno , Neoplasias Pleurais , Academias e Institutos , Autopsia , Humanos , Itália/epidemiologia , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/mortalidade , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/mortalidadeRESUMO
BACKGROUND: The occurrence of malignant mesothelioma is almost always causally associated to asbestos exposure but, considering women occurrences, this association is often difficult to demonstrate and consequently the asbestos exposure is defined as 'unknown'. OBJECTIVES: To describe the working activity and to give occupational asbestos exposure probability estimation related to an uncommon and poorly investigated productive sector: doll manufacture. METHODS: From the Province of Brescia Mesothelioma Registry, established in 1993 on population-based criteria, we have extracted the certified mesothelioma diagnosis cases, related to patients who were employed for some time in doll manufacture. RESULTS: Among the 757 total cases of malignant mesothelioma registered and studied up to 2016, we found 3 cases of pleural epithelial mesothelioma histologically diagnosed in young women who had worked in two doll manufacturing companies and whose asbestos exposure had been initially defined as 'unknown', because an environmental, family or extra-professional asbestos exposure was considered unlikely. However, the judicial autopsy performed on one of the 3 women had allowed examining lung tissue samples with Scanning Electron Microscopy. This technique showed a concentration of amphiboles fibers of about 12,000,000 per gram of dry lung tissue, with a consequent re-classification of asbestos exposure from 'unknown' to 'occupational certified'. DISCUSSION: Mesotheliomas in women with no apparent occupational asbestos exposure are normally referred to life or family environmental exposure. Moreover, it is known that occupational asbestos exposure in women is difficult to recognize. Previously, only one publication had reported two cases of mesothelioma in cloth doll manufacture. The occurrence of two mesothelioma cases in the same company out of the three here presented was suggesting an occupational exposure. The finding of a high amphibole fibers lung concentration confirmed the previous hypothesis, despite the impossibility to determine the circumstances with good evidence. CONCLUSION: The three cases of mesothelioma in doll production workers suggest that also in this restricted manufacturing sector had occurred an occupational asbestos exposure, which is up to now unknown and isn't due only to the use of sewing or ironing machines. The lung asbestos fibers burden analysis is confirmed to be a decisive factor in the assessment of mesothelioma cases with 'unknown' exposure.
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Amianto/efeitos adversos , Carcinógenos , Indústrias , Mesotelioma/etiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Neoplasias Pleurais/etiologia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Jogos e BrinquedosRESUMO
BACKGROUND & AIMS: Oxidative stress (OS) could play a role in metabolic syndrome-related manifestations contributing to insulin resistance (IR). The aim of the present study was to gain insight the relationships between OS, IR and other hormones involved in caloric balance, explaining the effects of a natural antioxidant-enriched diet in patients affected by metabolic syndrome. METHODS: We investigated the effects of dietary antioxidants on IR, studying 53 obese (20 males and 33 females, 18-66 years old, BMI 36.3 ± 5.5 kg/m2), with IR evaluated by Homeostasis Model Assessment (HOMA)-index, comparing 4 treatments: hypocaloric diet alone (group A) or plus metformin 1000 mg/daily (group B), natural antioxidants-enriched hypocaloric diet alone (group C) or plus metformin (group D). A personalized program, with calculated antioxidant intake of 800-1000 mg/daily, from fruit and vegetables, was administered to group C and D. The glycemic and insulinemic response to oral glucose load, and concentrations of total-, LDL- and HDL-cholesterol, triglycerides, uric acid, C reactive protein, fT3, fT4, TSH, insulin-like growth factor 1 were evaluated before and after 3-months. Plasma Total antioxidant capacity was determined by H2O2-metmyoglobin system, which interacting with the chromogen ABTS generates a radical with latency time (LAG) proportional to antioxidant content. RESULTS: Despite a similar BMI decrease, we found a significant decrease of HOMA and insulin peak only in group B and D. Insulin response (AUC) showed the greatest decrease in group D (25.60 ± 8.96%) and was significantly lower in group D vs B. No differences were observed in glucose response, lipid metabolism and TAC (expressed as LAG values). TSH values were significantly suppressed in group D vs B. CONCLUSIONS: These data suggest that dietary antioxidants ameliorate insulin-sensitivity in obese subjects with IR by enhancing the effect of insulin-sensitizing drugs albeit with molecular mechanisms which remain yet to be elucidated.
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In previous works we demonstrated an inverse correlation between plasma Coenzyme Q10 (CoQ10) and thyroid hormones; in fact, CoQ10 levels in hyperthyroid patients were found among the lowest detected in human diseases. On the contrary, CoQ10 is elevated in hypothyroid subjects, also in subclinical conditions, suggesting the usefulness of this index in assessing metabolic status in thyroid disorders. A Low-T3 syndrome is a condition observed in several chronic diseases: it is considered an adaptation mechanism, where there is a reduction in pro-hormone T4 conversion. Low T3-Syndrome is not usually considered to be corrected with replacement therapy. We review the role of thyroid hormones in regulation of antioxidant systems, also presenting data on total antioxidant capacity and Coenzyme Q10. Published studies suggest that oxidative stress could be involved in the clinical course of different heart diseases; our data could support the rationale of replacement therapy in low-T3 conditions.
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Antioxidantes/metabolismo , Doenças Cardiovasculares/metabolismo , Pneumopatias/metabolismo , Estresse Oxidativo , Hormônios Tireóideos/metabolismo , Antioxidantes/química , Doenças Cardiovasculares/patologia , Humanos , Hipertireoidismo/metabolismo , Hipertireoidismo/patologia , Pneumopatias/patologia , Espécies Reativas de Oxigênio/metabolismo , Hormônios Tireóideos/sangue , Ubiquinona/análogos & derivados , Ubiquinona/sangueRESUMO
Clinical evidence demonstrates that ubiquinol-10, the reduced active form of coenzyme Q10 (CoQ10H2), improves endothelial function through its antioxidant and probably its anti-inflammatory properties. We previously reported that a biomarker combination including miR-146a, its target protein IL-1 receptor-associated kinase (IRAK-1), and released interleukin (IL)-6, here collectively designated as MIRAKIL, indicates senescence-associated secretory phenotype (SASP) acquisition by primary human umbilical vein endothelial cells (HUVECs). We explore the ability of short- and long-term CoQ10H2 supplementation to affect MIRAKIL in HUVECs, used as a model of vascular aging, during replicative senescence in the absence/presence of lipopolysaccharide (LPS), a proinflammatory stimulus. Senescent HUVECs had the same ability as young cells to internalize CoQ10 and exhibit an improved oxidative status. LPS-induced NF-κB activation diminished after CoQ10H2 pretreatment in both young and senescent cells. However, short-term CoQ10H2 supplementation attenuated LPS-induced MIRAKIL changes in young cells; in senescent cells CoQ10H2 supplementation significantly attenuated LPS-induced miR-146a and IRAK-1 modulation but failed to curb IL-6 release. Similar results were obtained with long-term CoQ10H2 incubation. These findings provide new insights into the molecular mechanisms by which CoQ10H2 stems endothelial cell inflammatory responses and delays SASP acquisition. These phenomena may play a role in preventing the endothelial dysfunction associated with major age-related diseases.
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Envelhecimento/genética , Senescência Celular/genética , Inflamação/metabolismo , MicroRNAs/genética , Ubiquinona/análogos & derivados , Envelhecimento/metabolismo , Antioxidantes/metabolismo , Células Endoteliais/citologia , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Células Endoteliais da Veia Umbilical Humana , Humanos , Inflamação/tratamento farmacológico , Quinases Associadas a Receptores de Interleucina-1/metabolismo , Interleucina-6/metabolismo , Lipopolissacarídeos/farmacologia , MicroRNAs/metabolismo , NF-kappa B/metabolismo , Ubiquinona/administração & dosagem , Ubiquinona/genética , Ubiquinona/metabolismoRESUMO
Tumor suppressor protein p53 has been demonstrated to regulate genes involved in energy generating metabolic pathways and apoptosis. To date, a new field of research is the involvement of TP53 codon 72 (Arg72Pro) polymorphism in the diabetic disease. The aim of this study was to evaluate whether the genotype and the related genetic models of Arg72Pro polymorphism of TP53 (rs1042522) are associated with insulin resistance and its metabolic parameters in diabetic and non-diabetic subjects. We examined 335 type 2 diabetic patients (65.5 ± 8.4 years) and 367 non-diabetic subjects (60.5 ± 11.7 years). The results were validated in a validation sample consisting of 199 type 2 diabetic (66.2 ± 8.5 years) and 224 non-diabetic subjects (61.2 ± 12.7 years). In the study sample, the analysis of covariance, adjusted for the effects of age, gender and BMI, showed a significant genotype-diabetes effect on insulin resistance evaluated by HOMA-IR (p = 0.038). This result was mediated by variations in fasting plasma insulin (p = 0.027), as no TP53 genotype-diabetes effects were detected for fasting plasma glucose. In particular, in the diabetic subjects, Pro/Pro genotype was associated with lower values of HOMA-IR with respect to Arg/Arg (p = 0.013) and Arg/Pro (p = 0.006) carriers. No difference in HOMA-IR between diabetic and non-diabetic Pro/Pro carriers was found. Significant recessive model-diabetes interaction effects on fasting insulin and HOMA-IR adjusted for age, sex and BMI were found (p = 0.007 and p = 0.029, respectively). Linear regression analyses, based on the assumption of an additive genetic model adjusted for age, sex and BMI, highlight p53 gene-diabetes interaction effects on fasting insulin (ß = -1.27; p = 0.001) and HOMA-IR (ß = -0.22; p = 0.006). The results of statistical analyses on fasting insulin and HOMA-IR were all confirmed in the validation sample. Furthermore, the logistic regression models confirmed that the effect of HOMA-IR levels on diabetes was moderated by Pro/Pro genotype in both study and validation samples (OR = 0.29, p = 0.034, 95 % CI = 0.09-0.91, OR = 0.37, p = 0.035, 95 % CI = 0.15-0.93, respectively). Our findings suggest that p53 codon 72 (Arg72Pro) polymorphism influences insulin resistance in type 2 diabetic patients independently of body mass.
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Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Resistência à Insulina/genética , Proteína Supressora de Tumor p53/genética , Idoso , Glicemia/metabolismo , Índice de Massa Corporal , Códon/genética , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Metabolismo Energético/genética , Jejum , Feminino , Genótipo , Homeostase/genética , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores de RiscoRESUMO
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes, if not treated. International guidelines recommend screening "all or high-risk women" at the initial prenatal visit, when a fasting plasma glucose (FPG) between 92 and 126 mg/dL is diagnostic for GDM. However, glucose testing may be affected by a great pre-analytical variability (usually overlooked), due to, for example, kind of sample (serum/plasma), temperature of storage, time between blood draw and centrifugation (in-tube glycolysis), and use of a glycolysis inhibitor. So GDM may be easily missed. We aimed to evaluate the potential characteristics of this important issue. SUBJECTS AND METHODS: FPG was tested by both "routine" and "gold standard" protocols in 60 women at the first trimester of gestation, presenting for GDM screening. "Routine" blood plasma was collected in a tube with sodium fluoride, kept at room temperature, centrifuged, and tested 30-45 min after blood draw. "Gold standard" was a specimen from the same blood sample that was centrifuged within 5 min and tested together with the "routine" specimen. RESULTS: In the "routine" protocol, 10 mg/dL on average was lost for each determination. Thirteen cases of GDM and two of overt diabetes (FPG >126 mg/dL) were missed in this preliminary series. CONCLUSIONS: The risk for GDM underdiagnosis in the first half of pregnancy appears to be actual and wide. A closer collaboration between clinicians and pathologists is critical, allowing a stricter adherence to the laboratory guidelines to be ensured.
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Glicemia/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Gestacional/diagnóstico , Adulto , Diabetes Mellitus Tipo 2/sangue , Diabetes Gestacional/sangue , Jejum , Feminino , Teste de Tolerância a Glucose , Guias como Assunto , Humanos , Gravidez , Cuidado Pré-NatalRESUMO
Oxidative stress is a mechanism underlying different kinds of infertility in human males. However, different results can be observed in relation to the method used for its evaluation. Varicocele patients show a number of biochemical abnormalities, including an altered distribution of coenzyme Q between seminal plasma and sperm cells and also an apparent defect in the utilization of antioxidants. Moreover, an influence of systemic hormones on seminal antioxidant system was observed too. Finally, the effects of surgical treatment on oxidativestress indexes and the possible usefulness of some medical therapies, like coenzyme Q supplementation, are discussed. In conclusion, published data show a role of oxidative stress in varicocele-related male infertility, but at present we do not know the precise molecular mechanisms underlying these phenomena.
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Coenzyme Q(10) (CoQ(10)), also known as ubiquinone for its presence in all body cells, is an essential part of the cell energy-producing system. However, it is also a powerful lipophilic antioxidant protecting lipoproteins and cell membranes. Due to these two actions, CoQ(10) is commonly used in clinical practice in chronic heart failure, male infertility, and neurodegenerative disease. However, it is also taken as an anti-aging substance by healthy people aiming for long-term neuroprotection and by sportsmen to improve endurance. Many hormones are known to be involved in body energy regulation, in terms of production, consumption and dissipation, and their influence on CoQ(10) body content or blood values may represent an important pathophysiological mechanism. We summarize the main findings of the literature about the link between hormonal systems and circulating CoQ(10) levels. In particular the role of thyroid hormones, directly involved in the regulation of energy homeostasis, is discussed. There is also a link with gonadal and adrenal hormones, partially due to the common biosynthetic pathway with CoQ(10), but also to the increased oxidative stress found in hypogonadism and hypoadrenalism.
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Corticosteroides/metabolismo , Doenças do Sistema Endócrino/metabolismo , Hormônios Gonadais/metabolismo , Hormônios Tireóideos/metabolismo , Ubiquinona/análogos & derivados , Corticosteroides/sangue , Hormônios Gonadais/sangue , Humanos , Hormônios Tireóideos/sangue , Ubiquinona/sangue , Ubiquinona/metabolismoRESUMO
The dynamics of light particles in chaotic oscillating cellular flows is investigated both analytically and numerically by means of Monte Carlo simulations. At level of linear analysis (in the oscillation amplitude) we determined how the known fixed points relative to the stationary cellular flow deform into closed stable trajectories. Once the latter have been analytically determined, we numerically show that they possess the dynamical role of attracting all asymptotic trajectories for a wide range of parameters values. The robustness of the attracting trajectories is tested by adding a white-noise contribution to the particle equation of motion. As a result, attracting trajectories persist up to a critical Péclet number above which an average rising velocity sets in. Possible implications of our results on the long-standing problem related to the explanation of the observed oceanic plankton patchiness will be also discussed.
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Líquido Extracelular/fisiologia , Líquido Extracelular/efeitos da radiação , Modelos Biológicos , Plâncton/fisiologia , Plâncton/efeitos da radiação , Simulação por Computador , Luz , Doses de RadiaçãoRESUMO
Infertility is associated with oxidative stress, normally counterbalanced by different antioxidant systems. In order to explore the hormonal control of seminal plasma total antioxidant capacity (TAC) we evaluated TAC and hormone patterns in a group of unselected infertile patients and control subjects. One hundred and ten infertile patients (divided into 3 groups: inflammation, varicocele, and other etiologies) and 31 fertile men were examined, evaluating blood serum gonadotropins, testosterone, estradiol, free tri-iodothyronine, free tetraiodothyronine (FT4), thyrotropin, prolactin (PRL), seminal parameters, and TAC. TAC was measured using the H(2)O(2)-metmyoglobin system, which generates the spectroscopically detectable radical cation of the chromogenous compound 2,2(I)-azinobis (3-ethylbenzothiazoline-6-sulfonate). The "lag time" of its appearance is proportional to the antioxidant activity. Lag phase was significantly higher in varicocele vs controls, whereas it was lower in patients with inflammation vs varicocele or other kinds of infertility. The correlation analysis between hormones and seminal parameters showed an inverse correlation between PRL and sperm motility, and a direct correlation of TAC with PRL and FT4, but not with gonadotropins or gonadal steroids. Our data suggest that systemic hormones may play a role in regulating seminal antioxidant capacity. This is interesting also because some hormones, such as thyroid and pituitary hormones, are not usually tested in the first-level evaluation of male patients with fertility problems.
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Antioxidantes/análise , Sêmen/química , Testosterona/fisiologia , Hormônios Tireóideos/fisiologia , Adulto , Humanos , Peróxido de Hidrogênio/metabolismo , Infertilidade Masculina/etiologia , Masculino , Estresse Oxidativo , Prolactina/sangue , Análise de Regressão , Sêmen/efeitos dos fármacos , Motilidade dos Espermatozoides/efeitos dos fármacos , Testosterona/sangue , Hormônios Tireóideos/sangue , Varicocele/complicaçõesRESUMO
Biliopancreatic diversion (BPD) is a surgical procedure performed in patients with untreatable obesity and insulin resistance. The demonstrated metabolic and hormonal results of this procedure include the reversal of insulin resistance; an increase in diet-induced thermogenesis; and modifications of gut hormones, such as gastrin, enteroglucagon, neurotensin, and cholecystokinin. On the other hand, obesity is a condition of increased oxidative stress; however, few studies have investigated antioxidant systems in obese persons with BPD. To evaluate the metabolic status and antioxidant systems in such patients, we studied a group of 11 morbidly obese patients, aged 28 to 62 years, with a mean body mass index (BMI) of 54.71 +/- 2.52 kg/m(2), before and after successful BPD (mean post-BPD BMI, 44.68 +/- 1.51 kg/m(2)). A control group composed of 10 slightly overweight women, with a mean BMI of 28.5 +/- 0.72 kg/m(2), was also studied. Coenzyme Q(10) (CoQ(10)) levels (also normalized for cholesterol levels) and total antioxidant capacity in blood plasma were assessed in these populations. The most striking datum was the extremely low level of CoQ(10) in postoperative period (0.34 +/- 0.16 vs 0.66 +/- 0.09 mug/mL, P = .04); also, the data corrected for cholesterol levels presented the same pattern, with a more marked significance (152.46 +/- 11.13 vs 186.4 +/- 17.98 nmol/mmol, P = .001). This could be due to lipid malabsorption after surgery. In fact, the pre-BPD data present all the metabolic and hormonal characteristics of severe obesity; and after BPD, there was a net improvement in the metabolic parameters. The first pathophysiologic phenomenon seems to be lipid malabsorption that has been argued to be the cause of insulin resistance reversion. This metabolic interpretation is also confirmed by the absence of significant variations of total antioxidant capacity (57.5 +/- 5.3 vs 66 +/- 5.3). The mechanisms of these phenomena remain to be established. These data suggest the importance of correcting postsurgical metabolic complications, in these clinical populations, with CoQ(10) supplementation.
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Antioxidantes/metabolismo , Desvio Biliopancreático , Obesidade Mórbida/sangue , Obesidade Mórbida/cirurgia , Ubiquinona/análogos & derivados , Adulto , Benzotiazóis , Glicemia/metabolismo , Colesterol/sangue , Feminino , Humanos , Insulina/sangue , Resistência à Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Ácidos Sulfônicos/análise , Tiazóis/análise , Triglicerídeos/sangue , Ubiquinona/sangue , Ácido Úrico/sangueRESUMO
OBJECTIVE: To report a case of a 45,X man, a rare condition with a clinical course that has not been dealt with by any previous article in the literature. DESIGN: Case report. SETTING: University Genetic Center and Endocrine Clinic. PATIENT(S): A 41-year-old man, already known by our genetics center for a 45,X chromosome constitution and a normal male differentiation, came back with requests on his sexual and fertility potential. Twenty-one years ago, high-resolution analysis of prometaphase chromosomes revealed additional euchromatic material on a 15-p chromosome, and in situ hybridization with Y-specific probe pDP105 gave positive signal on 15p11.2, suggesting a t(Yp;15p) translocation. INTERVENTION(S): Fluorescence in situ hybridization analyses on metaphase chromosomes, standard oral glucose tolerance test, dynamic hormone assays, semen analysis, and dual-energy x-ray absorptiometry. MAIN OUTCOME MEASURE(S): Reexamination at clinical, genetic, hormonal, and metabolic level. RESULT(S): The derivative chromosome 15 was characterized as der(15)(Ypter-->q11.21::15p11.2-->qter). The patient's findings satisfied the criteria of the metabolic syndrome. Hypergonadotropinemic hypotestosteronemia was diagnosed. CONCLUSION(S): Our study offers new insights into the natural history of this condition and suggests that hypogonadism could play a role in the development of metabolic syndrome.
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Cromossomos Humanos Par 15 , Cromossomos Humanos X , Cromossomos Humanos Y , Fertilidade/genética , Hipogonadismo/genética , Síndrome Metabólica/genética , Translocação Genética , Absorciometria de Fóton , Adulto , Glicemia/metabolismo , Densidade Óssea/genética , Teste de Tolerância a Glucose , Hormônios/sangue , Humanos , Hipogonadismo/complicações , Hipogonadismo/metabolismo , Hipogonadismo/patologia , Hibridização in Situ Fluorescente , Masculino , Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Análise do Sêmen , Testículo/patologiaRESUMO
Oxidative stress is involved both in metabolic syndrome and male infertility. Hypogonadism is also associated with increased risk for cardiovascular disease. To investigate the role of gonadal steroids in systemic antioxidant regulation, we determined plasma CoenzymeQ(10) (CoQ(10)) and total antioxidant capacity (TAC) in postsurgical hypopituitaric patients. Twenty-six patients aged 28-55 years were studied 6-12 months after surgery. CoQ(10) levels were measured by high-performance liquid chromatography and TAC by spectroscopy with the use of the mioglobin-H(2)O(2) system, which, in interacting with chromogen 2,2(I)-azinobis-(3-ethylbenzothiazoline-6-sulfonate), generates a radical after a latency time (LAG) that is proportional to antioxidant content. Sixteen patients presented low testosterone values; in 10 patients hypogonadism was isolated, and in 6 patients hypothyroidism also was present. CoQ(10) levels were significantly lower in isolated hypogonadism than in normogonadism. Testosterone treatment, performed in those patients with isolated hypogonadism, induced a significant enhancement both in CoQ(10) level and LAG. CoQ(10) and LAG values correlated significantly, suggesting an interrelationship between different antioxidants. Our data suggest that hypogonadism could represent a condition of oxidative stress, in turn related with augmented cardiovascular risk.
Assuntos
Antioxidantes/metabolismo , Hipogonadismo/metabolismo , Estresse Oxidativo/fisiologia , Testosterona/metabolismo , Adulto , Cromatografia Líquida de Alta Pressão , Humanos , Hipogonadismo/etiologia , Hipopituitarismo/complicações , Masculino , Pessoa de Meia-Idade , Ubiquinona/análogos & derivados , Ubiquinona/sangueRESUMO
Motivated by the work of Li and Meneveau [Phys. Rev. Lett. 95, 164502 (2005)], we propose and solve a model for the Lagrangian evolution of both longitudinal and transverse velocity and temperature increments for Boussinesq convection. From this model, the short-time evolution of an initially imposed Gaussian joint probability density function (PDF) of both velocity and temperature increments is computed analytically and the trend to non-Gaussian statistics shown in a quantitative way. Predictions for moments of the joint PDF are obtained and their behavior analyzed with respect to known experimental and numerical results. The obtained results do not depend on the model free parameters, a fact in favor of their robustness.