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Abstract: Assisted reproduction techniques (ARTs) have given rise to novel, non-traditional family models. Still, among the various applications and approaches of 'medically assisted procreation' (MAP), the most divisive one undoubtedly is 'gestational surrogacy' (GS), also in light of the rising number of couples who have chosen it over the past twenty years. Another major implication of ARTs is the creation of intentional (or intended) parenthood in addition to genetic one: the genetic parent's partner is thus defined as the intentional (or second) parent, who by free choice, shares the family project with the genetic parent, even without any biological tie with the child. Hence, the intended parent takes on the same rights and responsibilities towards the child as the biological one. Several countries, including Italy, have enacted norms to discourage cross-border surrogacy, deeming it harmful to the dignity of women and children. Recently, however, the Italian government has decided intensify the fight against this practice: the Chamber of Deputies (Italy's lower chamber of parliament) has passed a law which punishes couples that resort to surrogacy even if the agreement and the birth take place abroad. Therefore, surrogacy would become a so-called universal crime. In light of the fact that criminalization is a serious and highly consequential step, which may have life-changing consequences for the intended parents, the aim of this paper is to assess whether this may be an effective instrument for regulating the interests at stake and, therefore, whether it would be desirable for other countries to follow such a model. Ultimately, it is worth remarking that for those who seek to achieve parenthood, such a desire is among the most profound aspects of a person's existential realization. When due to a delicate balance of ethics standards and potentially conflicting rights, lawmakers inter-vene, an authoritarian approach is unlikely to be beneficial. Offering real alternatives to surrogacy in an organic and pragmatic fashion (i.e. expediting adoption procedures, favoring motherhood at a younger age, when infertility issues are less likely to have set in) may be the best way to disincentivize fertility traveling and make sure the rights, hopes and aspirations of all the parties involved are upheld properly.
Assuntos
Mães Substitutas , Humanos , Mães Substitutas/legislação & jurisprudência , Itália , Feminino , Técnicas de Reprodução Assistida/ética , Técnicas de Reprodução Assistida/legislação & jurisprudência , Gravidez , Temas Bioéticos/legislação & jurisprudência , Turismo Médico/legislação & jurisprudência , Turismo Médico/ética , Pais , Crime/legislação & jurisprudência , CriançaRESUMO
Low socio-economic status is recognized as one of the risk factors for SIDS. In this study we have pointed out the similarities between families that have SIDS cases and families in which infant non-accidental injury has been proven, as well as the differences between them and the general population. This study was conducted in Montenegro, comparing 30 cases of SIDS with 25 cases of known infanticides and with a control group (60 cases) consisting of live newborns and their mothers from the general population, randomly selected from hospital-born newborns without exclusion criteria. We combined and compared the infant characteristics and mother characteristics between the above cases. There were significant similarities between the SIDS group and the infanticide group in terms of the following characteristics: the education level of the mothers (p = 0.086); maternal employment (p = 0.278); and place of residence (p = 0.269); while there were differences between the two groups regarding hospital birth (p = 0.027) and marital status (p = 0.011). The SIDS and infanticide groups, combined, had higher incidences of: out-of-hospital deliveries (p < 0.001); uneducated mothers (p < 0.001); unemployed mothers (p < 0.001); low socio-economic status (p < 0.001); and cases outside of marriage (p < 0.001), compared to the control groups. This study indicated a possible higher incidence of non-natural death among SIDS cases, as reflected by low socio-economic status and linked attributes, which is explained by their similarities with the infanticide groups and differences with the control groups.
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Infanticídio/estatística & dados numéricos , Classe Social , Morte Súbita do Lactente/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Parto Obstétrico/estatística & dados numéricos , Status Econômico/estatística & dados numéricos , Escolaridade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estado Civil/estatística & dados numéricos , Montenegro/epidemiologia , Adulto JovemRESUMO
Current estimates suggest that approximately 20% of women and 11% of men have been victims of intimate partner violence. Risk identification tools for repeated domestic violence currently exist and have typically been designed by police and judicial authorities, based on the criminal history of the perpetrator. A follow-up cohort study of 238 cases of intimate partner violence (judicially processed and officially judged as DV according to Montenegrin Criminal Act) was conducted by reviewing randomly selected court files. The results showed that certain perpetrator characteristics (unemployment, lack of regret, other violent criminal history, and history of being beaten by a family member) and victim characteristics (nonqualified education and predictions of future harm) were associated with reassault. Relationship characteristics such as different ethnicity, poor socioeconomic status, difference in incomes, living in a rental property, alcohol and drug use, and unprocessed previous history of physical violence were also associated with repeated violence. A risk identification tool for repeated intimate violence was computed based on the significant variables, with a sensitivity of 85% and a specificity of 89%. This study demonstrates a new tool for repeated intimate partner violence prediction in patriarchal societies, widespread in Eastern Europe and the Middle East. The majority of factors associated with reassault in this sample have been shown to be predictive for repeated intimate partner violence in previous studies. The applicability of our tool in egalitarian societies should be investigated in order to see whether the combination of these factors is universal or specific to patriarchal societies.
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Violência por Parceiro Íntimo , Medição de Risco/métodos , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Montenegro/epidemiologia , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
The brachial plexus represents a field of many anatomical variations with impor- tant clinical implications, especially in the diagnosis and treatment of the thoracic outlet syndrome (TOS). The case described in this paper presented a novel bilateral variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle. The ventral rami of the C5 and C6 spinal nerves perforated the anterior scalene muscle simultaneously through a common opening, and joined to form the upper trunk. Previous literature reports described variations of the brachial plexus and the scalene muscles, as well as the embryological basis for their presence. The case reported herein helps to improve the comprehension of the TOS, as well as the diagnostic and therapeutical approach to this syndrome.
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Plexo Braquial/anormalidades , Músculo Esquelético/anormalidades , Variação Anatômica , Cadáver , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The optic nerve (ON), a major component of the visual system, is divided into four segments: the intrabulbar (IB), the intraorbital (IO), the intraca- nalicular (ICn) and the intracranial (ICr). The ICr ends with the two nerves partially decussating in the optic chiasm (OCh). The purpose of this study is to provide a detailed description of the dimensions of the OC (the diameter and the surface area of its foramina and the central segment, as well as the length of the OC and the thickness of its walls) as well as the ON (the length of the ON segments, the diameter of the ICn segment of the ON, the angle of decussation in the OCh, as well as the distance between the two ON at the cranial foramen of the OC). MATERIALS AND METHODS: The acquired data was then used to estimate the volu- me of the OC and the ICn segment of the ON. The morphometric research was performed on 25 cadavers (17 male and 8 female) and 30 skulls. RESULTS: The surface area of the central segment of the OC was significantly smaller than the cranial foramen (p = 0.02) and the orbital foramen (p = 0.009). The inferior wall of the OC was significantly shorter than the other OC walls (p < 0.0001). The IO segment of the ON was the longest, where the difference to the ICn and ICr was statistically significant (p < 0.0001). The surface area of the ON at the cranial foramen was significantly larger than the surface area at the central segment of the OC (p = 0.02) and orbital foramen (p < 0.0001). The difference between the surface areas of the ON at the orbital foramen and the central segment of the OC was also statistically significant (p = 0.01). The estimated volume of the OC was calculated to be 190.72 mm3, and the volume of the ICn segment of the ON was estimated to be 50.25 mm3. CONCLUSIONS: It is absolutely crucial to open the central segment of the OC when decompressing the ON, due to the narrowing of the OC in this segment.
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The aim of this study is to determine the effect of combining extracorporeal shock-wave therapy (ESWT) and triple therapy versus triple therapy alone, when treating Category III B chronic prostatitis (CPPS). Study included 60 patients, classified as having CPPS, divided into two groups: the first group numbered 30 patients, who were treated with a combination of an α-blocker, an anti-inflammatory agent and a muscle relaxant; the second group consisted of 30 patients who received a combination of ESWT and the fore-mentioned triple therapy. Patients were treated for 12 weeks. The primary criterion of a response to therapy was scoring 2 or less on the NIH-CPSI quality of life item, while the secondary criterion of a response to therapy was a greater than a 50% reduction in NIH-CPSI pain score. Patients who received triple therapy did not show a significant change neither in post void residual urine (PVR) nor in maximum flow rate (QMAX), while the second group of patients exhibited significant improvement in both PVR and QMAX values. Both groups of patients showed statistically significant improvement in all items of the NIH-CPSI score after the treatment, with significantly better results in the second group.
Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Ondas de Choque de Alta Energia/uso terapêutico , Fármacos Neuromusculares/uso terapêutico , Dor Pélvica/terapia , Prostatite/terapia , Antagonistas Adrenérgicos alfa/administração & dosagem , Adulto , Anti-Inflamatórios/administração & dosagem , Terapia Combinada , Quimioterapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares/administração & dosagem , Medição da Dor , Dor Pélvica/etiologia , Prostatite/complicações , Prostatite/tratamento farmacológico , Qualidade de Vida , Resultado do TratamentoRESUMO
OBJECTIVE: The hypo-osmotic swelling (HOS) test predicts membrane integrity by determining the ability of the sperm membrane to maintain equilibrium between the sperm cell and its environment. The aim of our study was to determine the correlation between selenium and carnitine levels in the seminal fluid with HOS test for sperm membrane in low-grade varicocele patients. PATIENTS AND METHODS: Study numbered 64 examinees who suffered from low-grade varicocele and were divided into two groups, according to fertility potential and HOS test outcome. The study also included a control group of 64 healthy subjects, with no varicocele. RESULTS: From the Shapiro-Wilk's test, it is clear that carnitine distribution differs significantly from normal (0.938, p = 0.03). In distribution of selenium, Kolmogorov-Smirnov test clearly shows statistically significant deviation from the normal curve (z = 0.225, p < 0.000), likewise Shapiro-Wilk's statistic (0.787, p < 0.000). According to the results, the second group had significantly higher levels of carnitine and selenium than the first group of examinees (p < 0.05); therefore, when we compared epididymal markers with HOS tests outcomes, we found significant differences between the two groups. There were no significant differences between second group and healthy subjects (p > 0.05). CONCLUSIONS: HOS test outcome in varicocele patients is directly proportional to the carnitine and selenium levels, which could play a major role in both determining fertility parameters and in the treatment of its impairment. This result is important for sub-clinical varicocele in infertile patients with normal semen analysis, since there is no evidence of benefit from any treatment so far.
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Carnitina/metabolismo , Osmose/fisiologia , Selênio/metabolismo , Espermatozoides/metabolismo , Varicocele/diagnóstico , Varicocele/metabolismo , Adulto , Biomarcadores/metabolismo , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/metabolismo , Masculino , Motilidade dos Espermatozoides/fisiologiaRESUMO
OBJECTIVE: An aortic aneurysm is a general term for an enlargement (dilation) of the aorta to greater than 1.5 times normal size. Abdominal aortic aneurysm (AAA) primarily affects the population older than 50 years, with a prevalence of approximately 5%. There are a few theories about AAA etiology. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood-groups among the patients with abdominal aortic aneurysm (AAA) as well as to identify any kind of relationship between blood type and AAA. MATERIALS AND METHODS: The design of our research is combination of retrospective and prospective case-control study in a sample of population of Montenegro. Statistical analysis was performed in SPPS v 20.0, using the chi-square test for independent samples, with the probability level at p < 0.05 as significant, and p < 0.01 as highly significant. RESULTS: O blood group was the most frequent among the examination group (53.11%), and A blood group was the most frequent among group without AAA (43.22%). Presence of AAA in individuals with O blood type was 1.46 higher than for the other blood types. CONCLUSIONS: This finding leads us to suspect that O blood type can be indicator for AAA.
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Aneurisma da Aorta Abdominal/diagnóstico , Antígenos de Grupos Sanguíneos/efeitos adversos , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos RetrospectivosRESUMO
The tensor fasciae latae (TFL) muscle is commonly used in plastic and reconstructive surgery as a transpositional or a free flap, in order to repair different kinds of defects. In most cases its vascularisation is provided by an ascending branch of lateral circumflex femoral artery (LCFA), which gives different numbers of branches and enters the TFL muscle in different manners. The represented study deals with the arterial vascularisation of the TFL muscle: the entrance of the vascular stalk branches; variations of the LCFA bifurcation's angle; and the skin area of vascularisation. The study was performed on both lower limbs of a 100 foetal and 10 adult cadavers. The LCFA was injected with micropaque solution, afterwards fixed and preserved in 10% formalin solution. Microdissection was performed under magnifying glass and surgical microscope. Analysis of adult cadavers was performed to determine the skin area vascularised by perforating blood vessels from the TFL muscle, by injecting methylene-blue dye into the artery, prior to which all branches of the LCFA, besides the ascending branch, were ligated. The research of a 100 foetal cadavers showed that the LCFA with its ascending branch ensured the blood supply to the muscle. In 85% it gave two branches, the ascending and the descending one, with the angle of bifurcation circa 90o in 73% of cases. The ascending branch can give 0 or more terminal branches, or even form an arterial net. Skin area affected with dye ranged from 18 × 22 cm to 23 × 28 cm and is in positive correlation with the LCFA length and diameter. The understanding of the presented variations have an exceptional significance in planning and applying the TFL flap, especially free flap, in successful repairing and covering the defects, as well as in preventing postoperative complications.
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OBJECTIVE: Malignancies and autoimmune thyroid disease are still controversial, but recent studies prove that a long lasting thyroid disease may be linked with malignancy, e.g. papillary thyroid carcinoma in patients with Hashimoto thyroiditis. Having in mind that thyrotropin is a thyroid growth factor, the relationship between its serum values, as well as the levels of anti-peroxidase and anti-thyroglobulin antibodies and thyroid malignancy in patients with nodular thyroid goiter was examined. PATIENTS AND METHODS: Six-hundred-thirty-seven medical records, which included the thyroid fine-needle aspiration cytology were retrospectively evaluated. Patients were grouped regarding the levels of thyrotropin, anti-peroxidase and anti-thyroglobulin antibodies (in or out of the reference ranges) and compared with cytology findings for establishing their prognostic potential for malignancy. RESULTS: Elevated serum thyrotropin (≥ 4.5 mIU/L) was found in 27.3% of patients with thyroid malignancy compared with 10.8% with benign and 16.1% with unspecified cytology finding (p < 0.01). In the group of patients with malignant cytology findings 7.0% of them had elevated anti-peroxidase antibodies level, and 1.4% had anti-peroxidase antibodies level in reference range. In the group of patients with malignant cytology findings 4.2% of them had elevated anti-thyroglobulin antibodies level, and 1.4% had anti-thyroglobulin antibodies level in reference range. CONCLUSIONS: In patients with elevated serum thyrotropin concentration and/or chronic thyroiditis the occurrence of thyroid malignancy is increased.
Assuntos
Autoanticorpos/sangue , Autoimunidade/fisiologia , Biomarcadores Tumorais/sangue , Neoplasias da Glândula Tireoide/sangue , Tireotropina/sangue , Adulto , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/imunologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/imunologia , Tireotropina/imunologiaRESUMO
OBJECTIVE: Thyroid disease is the second most common endocrine condition in women of childbearing age. Thyroid hormones are involved in control of menstrual cycle and in achieving fertility affecting the actions of follicle-stimulating hormone and luteinizing hormone on steroid biosynthesis by specific triiodothyronine sites on oocytes; therefore, affect all aspects of reproduction. It remains controversial if pregnant women should be screened for thyroid dysfunction. Purpose of this review was to examine recent studies on the assessment of thyroid dysfunction in pregnancy, its treatment and newly perspective of thyroid autoimmunity in pregnant euthyroid women in achieving fertility. METHODS: An electronic search was conducted using the internet medical databases: Medline/PubMed, EMBASE, EBSCO, and the Cochrane library. RESULTS: Thyroid gland faces great challenge in pregnancy when many hormonal changes occur. Precondition for normal follicular development and ovulation is pulsate gonadothropin realizing hormone secretion. Thyroid dysfunction in pregnancy is classified as forms of hypothyroidism (positivity of thyroid autoantibody, isolated hypothyroidism, and subclinical or overt hypothyroidism), hyperthyroidism, and autoimmune disease, but also thyroid nodules and cancer, iodine insufficiency and postpartum thyroiditis. These conditions can cause adverse effects on mother and fetus including pregnancy loss, gestational hypertension, or pre-eclampsia, pre-term delivery, low birth weight, placental abruption and postpartum hemorrhage. There is an evidence that thyroid autoimmunity, in thyroid dysfunction adversely affects conception and pregnancy outcomes, but it is unclear what impact has isolated eumetabolic thyroid autoimmunity in achieving fertility, especially in women undergoing in vitro fertilization. Treatment of euthyroid pregnant women with positive thyroid peroxides antibodies is still controverse, but not few studies show that levothyroxine substitution is able to lower the chance of miscarriage and premature delivery. CONCLUSIONS: Further randomized trials are needed to expand our knowledge of physiologic changes in thyroid function during the pregnancy and to reveal mechanisms by which thyroid autoimmunity in euthyroid women affect fertility, especially the success of assisted reproductive technology in achieving the same and validity of levothyroxine administration in thyroid autoimmunity positive women.
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Hipotireoidismo/sangue , Hipotireoidismo/imunologia , Infertilidade Feminina/sangue , Infertilidade Feminina/imunologia , Complicações na Gravidez/sangue , Complicações na Gravidez/imunologia , Adulto , Doenças Autoimunes/sangue , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Feminino , Hormônio Foliculoestimulante/sangue , Hormônio Foliculoestimulante/imunologia , Humanos , Hipotireoidismo/diagnóstico , Infertilidade Feminina/diagnóstico , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/imunologia , Gravidez , Complicações na Gravidez/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Técnicas de Reprodução Assistida , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/imunologiaRESUMO
OBJECTIVE: Varicocelectomy is the only effective method of treating varicocele. Nowdays, many techniques for varicocelectomy include retroperitoneal, inguinal, and subinguinal varicocele repairs with or without magnification and laparoscopic repair. The advantages of the microsurgical approach to varicocele repairs are reliable identification and preservation of the vascular structures. Thus, our aim is to compare the efficiency of microsurgery over conventional techniques of varicocele repairs. PATIENTS AND METHODS: We have evaluated 105 man divided into three groups of 35 patients surgically treated with open varicocelectomy in the first group, microsurgical varicocelectomy in the second, and laparoscopic varicocelectomy in the third group. Sperm test improvement and complications were then compared. RESULTS: The testicular volume shows a significant increase after all three types of surgery, the highest one being after the laparascopic varicocelectomy (14.47 ± 6.76 vs. 21.8 ± 7.52), whereas the lowest increase was recorded in open varicocelectomy (14.90 ± 6.26 vs. 17.46 ± 5.89). Regarding motility of spermatozoids, the highest postoperative increase of values is after microsurgical varicocelectomy (4.30 ± 2.19 vs. 15.88 ± 3.13). CONCLUSIONS: Our study shows the lowest degree of postoperative complications among patients treated with microsurgical varicocelectomy, and the most frequent complications in those treated by open varicocelectomy. Sperm test outcomes after microsurgical varicocelectomy was better than those after other conventional techniques: significantly higher improvement of sperm quality, shoter postsurgical clinical treatment, and the lowest rate of postsurgical complications.
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Microcirurgia , Varicocele/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Adolescente , Adulto , Humanos , Laparoscopia , Tempo de Internação/estatística & dados numéricos , Masculino , Tamanho do Órgão , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Estudos Retrospectivos , Análise do Sêmen , Testículo/patologia , Varicocele/epidemiologia , Varicocele/patologia , Cicatrização , Adulto JovemRESUMO
BACKGROUND: A small amount of data is already presented in the relevant literature related to the medical facts of scorpionism caused by Yellow scorpion (Mesobuthus gibbosus: M. gibbosus). Undoubtedly, it is considered as dangerous to human health. This paper presents an unusual case of scorpionism after the sting in vein. CASE REPORT: A 25 year old male was bitten by M. gibbosus. He experienced extremely severe intermittent pain in the right feet, followed by pulsating and glowing sensations, cold sweat and paleness. 15 minutes after the sting, the pain started to spread through the medial side of the leg, up to the inguinal region. Patient became excited, and experienced occasional spasms of leg muscles. A month after, the bitten vein of dorsal arch of the foot and v. sephena magna became non-uniformly tortuously spread through the entire length. On physical examination four years after the sting, the enlargement of the veins still exists, periodical tingling, and occasional muscle twitches during the night. CONCLUSIONS: M. gibbosus is endemic in Mediterranean area and represents a real hazard for local inhabitants and tourists. The medical treatment of this type of scorpionism is exclusively symptomatic.
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Pé/irrigação sanguínea , Flebite/etiologia , Picadas de Escorpião/complicações , Escorpiões , Adulto , Animais , Doença Crônica , Humanos , Masculino , Dor/etiologia , Flebite/diagnóstico , Flebite/tratamento farmacológico , Picadas de Escorpião/diagnóstico , Picadas de Escorpião/tratamento farmacológico , Espasmo/etiologia , Sudorese , Fatores de Tempo , Veias/patologiaRESUMO
Variations of the brachial plexus and its terminal branches are not uncommon.Therein, the anatomical variations of the musculocutaneous and the median nerve are classified into 5 types, while the communicating branches between the musculocutaneous and the median nerve are classified into 3 types, depending on their position related to the coracobrachial muscle. The case reviewed in this paper presents a variation similar to that of the second variety, but is significantly different due to the appearance of the proximal musculocutaneous nerve and its communicating branching, the site rising from the communicating branch (through the coracobrachial), and important clinical implications of this new variation. Despite the communicating branch being located in the upper third of the upper arm, it should not be considered as being a double lateral root of the median nerve.
Assuntos
Nervo Mediano/anormalidades , Nervo Musculocutâneo/anormalidades , Cadáver , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Diabetic patients have a double higher short-term mortality rate after acute myocardial infarction (AMI) than non-diabetic ones. Admission glucose level has been already concerned as an independent risk factor for the long-term prognosis after myocardial infarction. The aim of this study is to evaluate the influence of admission glucose profile (AGP) and glycosylated hemoglobin (HbA1c) on complications of the AMI in patients with type 2 diabetes. PATIENTS AND METHODS: The study was based on 76 diabetic patients hospitalized with first-ever AMI. Admission glucose profile was estimated as mean value of the first six blood glucose values, since HbA1c was measured from the blood sampled in the first morning after the admission to hospital. All post-infarction complications are divided into electrical and mechanical ones. ROC curves are used to analyze predictive values of admission glucose profile and HbA1c for developing post-infarction complications. RESULTS: Admission glucose profile is a significant (p = 0.001) predictor of electrical complications with 12.25 mmol/L cut-off value (sensitivity 77.3%; specificity 64.5%), while it is not significant (p > 0.05) for mechanical complication (cut-off value 16.85 mmol/L; sensitivity 45.2%; specificity 77.8%). HbA1c is not enough good for the complication prediction (p > 0.05). Considering electrical and mechanical complications aggregately, AGP is even more significant (p = 0.000) with 14.85 mmol/L cut-off value (sensitivity 54.4%; specificity 94.7%), and HbA1c is significant, as well (p = 0.013, too with 9.07 % cut-off value (sensitivity 57.9%; specificity 78.8%). CONCLUSIONS: Comparing the predictability between AGP and HbA1c, in our sample, the first one seems to be the better one. Admission glucose profile and HbA1c should be the obligatory laboratory tests performed at the time of hospital admission after the heart attack.
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Glicemia/análise , Cardiomiopatias Diabéticas/sangue , Cardiomiopatias Diabéticas/complicações , Hemoglobinas Glicadas/análise , Infarto do Miocárdio/sangue , Infarto do Miocárdio/complicações , Doença Aguda , Adulto , Idoso , Área Sob a Curva , Diabetes Mellitus Tipo 2/complicações , Eletrofisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROCRESUMO
BACKGROUND: Varicocele associated with infertility has been recognized for years. Referential literature provides few papers, even meta-analyses which did not confirm the success of surgery related to the increasing of the semen quality. AIM: The purpose of the presented paper is referred in arising the quantum of knowledge related to usefulness of surgery in varicocele treatment. PATIENTS AND METHODS: The varococele incidence was established in premature age (7-18) in population of 969 boys. In those who suffered from varicocele, we estimated their semen analysis parameters before and three months after the surgery, and followed up the pregnancy rate in surgically treated subjects many years after the treatment. RESULTS: A prevalence of 9.7% in premature age, significantly raising in the group aged 15-18 was showed. After the laparoscopic varicocelectomy, all of the semen parameters (left testicular volume, pH, sperm count, abnormal forms and viability) were improved, since the semen volume and the progressive motility not significantly. Since we observed adolescent varicocele, some of the semen parameters initialy have not been out of reference limits. Following the surgically treated subjects for next 12-17 years, the pregnancy rate is at least 75%, since not all of them have been married yet. CONCLUSIONS: We recorded improvement of two out of three parameters of fertility after the operation in a group of 23 surgically treated patients. This fact encourages those who advocate surgical treatment of varicocele in adolescents, since the early therapy would prevent fertility disorders.
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Fertilidade , Laparoscopia/métodos , Varicocele/cirurgia , Adolescente , Criança , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Varicocele/fisiopatologiaRESUMO
Pyospermia is the abnormally high concentration of white blood cells in human ejaculate, as caused by a bacterial infection. This study addresses the evaluation of the use of an antibiotic treatment in infertile patients who show asymptomatic pyospermia through the monitoring of semen analysis parameters. The study was carried out on 60 infertile patients who were diagnosed with asymptomatic genital infections, focused on pyospermia caused by Chlamydia trachomatis and Ureaplasma urealyticum. The volume of the ejaculate, pH, sperm concentration and progressive motility, as well as the viability of the spermatozoa and their morphology, were all observed before therapy, 10 and 30 days after. Patients were treated with antibiotics in accordance with the recommendations given by the European Urology Association. The results showed a clear effect of antibiotic therapy on the volume and pH of the seminal fluid; moreover, only 30 days after completion of the therapy sperm concentration itself significantly increased, and progressive motility greatly improved, albeit slowly. However, it must be noted that the antibiotic therapy had no significant effect on the viability of the spermatozoa within 30 days of beginning the treatment.
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Antibacterianos/uso terapêutico , Infecções por Chlamydia/tratamento farmacológico , Infertilidade Masculina/tratamento farmacológico , Infecções do Sistema Genital/tratamento farmacológico , Infecções por Ureaplasma/tratamento farmacológico , Adulto , Infecções por Chlamydia/complicações , Chlamydia trachomatis , Humanos , Infertilidade Masculina/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções do Sistema Genital/complicações , Análise do Sêmen , Infecções por Ureaplasma/complicações , Ureaplasma urealyticum , Adulto JovemRESUMO
After a short review of impotence, the definitions of erectants and aphrodisiacs are presented. The Authors propose division of arthropods according to the places of effect. The description of particular arthropods with their pictures and nomenclature, is followed by certain or probable mechanisms of achieving the aphrodisiac and sometimes toxic effect, that were available in the literature since 1929 till nowadays. We mention the most usual locations, mainly in Asia, where they are found and consumed, but also, we describe the manner of preparing and intake. The review includes the following arthropods: lobster, Arizona bark scorpion, deathstalker, banana spider, Mediterranean black widow, Burmeister's triatoma, giant water bug, diving-beetle, Korean bug, diaclina, flannel moth, Spanish fly, migratory locust, red wood ant and honeybee.
Assuntos
Afrodisíacos/uso terapêutico , Artrópodes/química , Disfunção Erétil/tratamento farmacológico , Ereção Peniana/efeitos dos fármacos , Animais , Afrodisíacos/isolamento & purificação , Artrópodes/classificação , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Medicina Tradicional , Resultado do TratamentoRESUMO
Specific in vivo T cell activation initiated by treatment with anti-CD3 antibodies leads to diarrhea and structural damage of the intestinal mucosa. In this study, the effect of T cell-induced mucosal damage on jejunal epithelial ion transport, muscle contractility, and neuronal ACh release was assessed in Ussing chambers, organ baths, and a specialized perfusion apparatus, respectively. Time-matched control mice received hamster serum containing irrelevant antibodies. Jejunal segments from anti-CD3-treated mice displayed a significantly elevated epithelial baseline short-circuit current (which indicates increased ion transport) and a concomitant reduction in responsiveness to prosecretory stimuli (nerve stimulation, carbachol, and forskolin). Longitudinal smooth muscle displayed altered spontaneous contractile activity, length-tension relationships, and carbachol-stimulated contraction in tissues excised from mice 20 and 40 h posttreatment. Anti-CD3 treatment did not affect stimulated ACh release from myenteric plexus neurons. We conclude that specific T cell activation via anti-CD3 antibody results in dramatic alterations in jejunal epithelial and smooth muscle function. Such T cell-induced changes in intestinal function may contribute to the symptomatology of T cell-mediated enteropathies, including graft-versus-host disease, celiac disease, and idiopathic inflammatory bowel disease.