Galectin 3-binding protein (LGALS3BP) depletion attenuates hepatic fibrosis by reducing transforming growth factor-ß1 (TGF-ß1) availability and inhibits hepatocarcinogenesis.

BACKGROUND: Increased Galectin 3-binding protein (LGALS3BP) serum levels have been used to assess hepatic fibrosis stages and the severity of hepatocellular carcinoma (HCC). Considering the crucial role of transforming growth factor-ß1 (TGF-ß1) in the emergence of these diseases, the present study tested the hypothesis that LGALS3BP regulates the TGF-ß1 signaling pathway. METHODS: The expression levels of LGALS3BP and TGFB1 were analyzed in patients with metabolic dysfunction-associated steatohepatitis (MASH) and HCC. Multiple omics techniques, such as RNA-sequencing, transposase-accessible chromatin-sequencing assay, and liquid chromatography-tandem mass spectrometry proteomics, were used to identify the regulatory mechanisms for the LGALS3BP-TGF-ß1 axis. The effects of altered TGF-ß1 signaling by LGALS3BP were investigated in conditional LGALS3BP-knockin and LGALS3BP-knockout mice. RESULTS: In patients with MASH and HCC, the levels of LGALS3BP and TGFB1 exhibited positive correlations. Stimulation of LGALS3BP by the inflammatory cytokine interferon α in HCC cells or ectopic overexpression of LGALS3BP in hepatocytes promoted the expression levels of TGFB1. Aggravated fibrosis was observed in the livers of hepatocyte-specific LGALS3BP-knockin mice, with increased TGFB1 levels. LGALS3BP directly bound to and assembled integrin αV, an integral mediator required for releasing active TGF-ß1 from extracellular latent complex with the rearranged F-actin cytoskeleton. The released TGF-ß1 activated JunB transcription factor, which in turn promoted the TGF-ß1 positive feedback loop. LGALS3BP deletion in the hepatocytes downregulated TGF-ß1 signaling and CCl4 induced fibrosis. Moreover, LGALS3BP depletion hindered hepatocarcinogenesis by limiting the availability of fibrogenic TGF-ß1. CONCLUSION: LGALS3BP plays a crucial role in hepatic fibrosis and carcinogenesis by controlling the TGF-ß1 signaling pathway, making it a promising therapeutic target in TGF-ß1-related diseases.

Olfactory Dysfunctions and Chronic Kidney Disease: A Scoping Review.

Chronic kidney disease (CKD) represents a significant global public health challenge. Among the various clinical complications associated with CKD, olfactory dysfunction has been identified as a factor that substantially affects the quality of life of patients. This study aims to systematically explore the prevalence, implications, and therapeutic avenues of anosmia in CKD patients. This scoping review utilized the Arksey and O'Malley framework, incorporating the Joanna Briggs Institute methodology, and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. The research question, formulated using the PIO framework, guided a thorough search of databases PubMed/Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library and gray literature sources. Eligibility criteria focused on studies involving CKD patients with olfactory dysfunctions. From an initial pool of 832 articles, 17 studies met the criteria, providing insights into olfactory alterations in 4,025 CKD patients. The data that have been reported, define that 55,34% of the sample experienced olfactory changes and the 8.5% experienced anosmia. This review revealed a complex interplay of factors contributing to olfactory alterations, including uremic toxins, dialysis procedures, electrolyte imbalances, and malnutrition. Findings suggested the potential recovery of olfactory function following kidney transplantation. Various assessment tools were utilized, with the University of Pennsylvania Smell Identification Test and Sniffin' Sticks emerging as the primary instruments. The observed variability in findings highlights the need for continued research to understand the mechanisms, enhance therapies, and improve quality of life for CKD patients with olfactory dysfunctions. Future studies should employ standardized methods, explore new assessment tools, and prioritize longitudinal assessments to advance our understanding and management of olfactory dysfunctions in this population.

The Role Played by Mitochondria in Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) refers to an endocrine disorder syndrome that are correlated with multiple organs and systems. PCOS has an effect on women at all stages of their lives, and it has an incidence nearly ranging from 6% to 20% worldwide. Mitochondrial dysfunctions (e.g., oxidative stress, dynamic imbalance, and abnormal quality control system) have been identified in patients and animal models of PCOS, and the above processes may play a certain role in the development of PCOS and its associated complications. However, their specific pathogenic roles should be investigated in depth. In this review, recent studies on the mechanisms of action of mitochondrial dysfunction in PCOS and its associated clinical manifestations are summarized from the perspective of tissues and organs, and some studies on the treatment of the disease by improving mitochondrial function are reviewed to highlight key role of mitochondrial dysfunction in this syndrome.

Exploring the complexities of 1C metabolism: implications in aging and neurodegenerative diseases.

The intricate interplay of one-carbon metabolism (OCM) with various cellular processes has garnered substantial attention due to its fundamental implications in several biological processes. OCM serves as a pivotal hub for methyl group donation in vital biochemical reactions, influencing DNA methylation, protein synthesis, and redox balance. In the context of aging, OCM dysregulation can contribute to epigenetic modifications and aberrant redox states, accentuating cellular senescence and age-associated pathologies. Furthermore, OCM's intricate involvement in cancer progression is evident through its capacity to provide essential one-carbon units crucial for nucleotide synthesis and DNA methylation, thereby fueling uncontrolled cell proliferation and tumor development. In neurodegenerative disorders like Alzheimer's and Parkinson's, perturbations in OCM pathways are implicated in the dysregulation of neurotransmitter synthesis and mitochondrial dysfunction, contributing to disease pathophysiology. This review underscores the profound impact of OCM in diverse disease contexts, reinforcing the need for a comprehensive understanding of its molecular complexities to pave the way for targeted therapeutic interventions across inflammation, aging and neurodegenerative disorders.

Improvement of symptoms and coronary perfusion gradient with mechanical left ventricular unloading in flow-limiting complex spontaneous coronary artery dissection, without revascularization.

Spontaneous coronary artery dissection (SCAD) can lead to acute coronary syndrome and sudden cardiac death, particularly in young women. Observational data show that, in SCAD patients, both percutaneous coronary intervention and coronary artery bypass grafting seem to be hampered by higher technical complexity, lower success rates, and worse outcomes. As spontaneous healing is a common occurrence, expert consensus advices medical management of the acute phase, when feasible. We present the case of a young woman with SCAD of left anterior descending artery causing myocardial infarction with ST-segment elevation. High-anatomical complexity and unstable conditions of the patient made both medical management and immediate revascularization unfeasible options. Therefore, we decided to implant a percutaneous off-loading mechanical support device to improve coronary perfusion pressure by unloading the left ventricle and preserve cardiac function, preventing worse complications of acute myocardial infarction. This strategy was successful in stabilizing the patient, until the definitive revascularization treatment became an option.

Prevalence of "uncomplicated" and "complicated" stress urinary incontinence in Argentinian women: Assessing the role of the urodynamic study.

OBJECTIVE: To determine the percentage of Argentinian patients with "uncomplicated" and "complicated" stress urinary incontinence (SUI) in whom preoperative urodynamics study (UDS) was performed. The secondary objective of the study was to evaluate differences between clinical observation and urodynamics in both groups of women. METHODS: A retrospective study of women with IOE derivatives for UDS prior to surgical treatment is performed. The analyzed patients were classified in complicated and not complicated according to the criteria of the study VALUE. The prevalence of different urodynamics observations was assessed in patients with complicated and uncomplicated SUI. RESULTS: We studied 792 patients with SUI derivatives for UDS. Of the patients studied, 313 (39.5%) were considered as uncomplicated SUI and 479 (60.5%) as complicated SUI. The Urodynamics observation was considered different from the clinical data in 415/792 (52.4%), although in greater proportion in SUI complicated (59.9% vs. 40.9%, p < 0.001). There was a higher incidence of voiding dysfunction in patients with complicated SUI (32.4% vs. 14.7%, p < 0,001). CONCLUSIONS: Patients with uncomplicated SUI represent 39% of patients studied with SUI. The differences between clinical evaluation and urodynamics are higher in patients with complicated SUI contributing new information in 60% of the cases.

[Evaluation of the microcirculation in critically ill patients : Relevance, practical possibilities and scientific evidence]. / Evaluation der Mikrozirkulation bei kritisch kranken Patienten : Relevanz, praktische Möglichkeiten und wissenschaftliche Evidenz.

As one critical parameter for organ perfusion, microcirculation and its monitoring are gaining increasing attention for modern intensive care medicine. The growing understanding of its importance in organ failure and the improved modes of its visualization mark microcirculation as an interesting target. Surrogate parameters for organ perfusion, like re-capillarization ("Recap") time, the "mottling score" or the measurement of serum lactate have long been established in clinical practice. A growing body of evidence is hinting towards online visualization of sublingual microcirculation using intravital video microscopy, which was shown to be of prognostic value. Furthermore, the measurement of objective and reproducible parameters hint towards use in individualized hemodynamic therapy.

Fractions from Annona muricata attenuate oxidative stress in pancreatic tissues, inhibits key carbohydrate digesting enzymes and intestinal glucose absorption but enhances muscle glucose uptake.

The ameliorating effect of different fractions of Anonna muricata ethanol leaves extract in oxidative pancreatic injury as well as their antihyperglycemic effect were investigated in vitro and ex vivo. Oxidative pancreatic injury was induced by incubating pancreatic tissue with ferrous sulphate (FeSO4 ). The antioxidative potentials of the fractions together with its ability to inhibit carbohydrate digesting enzymes, intestinal glucose absorption, and its ability to modulate muscle glucose uptake were determined. All the fractions significantly scavenge free radicals in dose-dependent manner and increase significantly increase the catalase and superoxide dimutase level thereby ameliorating lipid peroxidation. All the fractions also inihibited glucose digesting enzymes and absorption in dose-dependent manner. Glucose uptake was enhanced by the fractions in isolated psoas muscle of rats. The ethyl acetate fraction showed more potent amelioration and anti-hyperglycemic potentials among all the fractions. This could be further exploited as therapeutic strategy for the management of postprandial hyperglycemia as well as T2D. PRACTICAL APPLICATIONS: Annona muricata is among the edible fruits in the world with reported nutritional as well as medicinal values. The anticancer activity of the leaves and the fruits have been reported. Its ability to inhibit carbohydrate digesting enzymes and absorption and enhancing muscle glucose uptake as well as protection of pancreatic ß-cell from oxidative damage further support its reported antidiabetic properties. A. muricata provided a cheap and alternative source of nutraceuticals, which could be further exploited as therapeutic strategy for the treatment of postprandial hyperglycemia in T2D.

Stiff left atrial syndrome after low-dose radiotherapy for right breast cancer: The need for invasive hemodynamics at exercise.

Stiff left atrial (LA) syndrome is a distinct phenotype of heart failure with preserved ejection fraction, characterized by predominant high LA pressure. We describe the case of a middle-aged woman who developed exertional breathlessness during low-dose radiotherapy for right breast cancer and who was eventually found to be affected by stiff LA syndrome. Invasive hemodynamics allowed the recognition of pathognomonic tall V waves in the wedge position during exercise, in spite of inconclusive noninvasive investigations.

Vestibular Dysfunction in Children Suffering from Otitis Media with Effusion: Does Grommet Help? An Observational Study Using Computerized Static Posturography.

Otitis media with effusion (OME) has a detrimental effect on balance, which may not present as a clear symptom in children. This effect can be improved by the insertion of ventilation tubes. This study assesses balance in children suffering from OME pre and post operatively using computerized static posturography. 50 children of 3-6 years, suffering from OME were included in this observational descriptive study. These patients underwent myringotomy and grommet insertion. The balance was evaluated pre and post operatively after 3 months using computerized static posturography with Modified Clinical Test of Sensory Interaction on Balance under four conditions, namely eyes open/closed on firm surface/foam. Posturography mean sway velocity was deranged in these children preoperatively and it showed statistically significant improvement post operatively at 3 months. There is occult vestibular dysfunction in children with OME as assessed by static posturography which improves significantly 3 months after myringotomy and grommet insertion.

Tighter Blood Pressure Control Is Associated with Lower Incidence of Erectile Dysfunction in Hypertensive Men.

INTRODUCTION: Tighter blood pressure control is widely thought to be associated with better erectile function, although the preponderance of data is limited to dichotomous representations of hypertension without an attempt to look at degree of blood pressure control. AIM: To determine the association between optimal blood pressure control over time and the development of erectile dysfunction (ED) in a cohort of potent men. METHODS: We performed a retrospective cohort study of newly diagnosed hypertensive men without major medical comorbidities in an integrated healthcare system. Patients were stratified by exposure to hypertension, with varying levels of blood pressure control, as measured by ordinal categories of systolic blood pressure and deviation from the mean systolic pressure. MAIN OUTCOME MEASURES: Incidence of ED was defined by at least 2 primary care or urology diagnoses of ED in our electronic health records within 2 years, at least 2 filled prescriptions for ED medications within 2 years, or 1 diagnosis of ED and 2 filled prescriptions for ED medications. RESULTS: We identified 39,320 newly diagnosed hypertensive men. The overall incidence for ED was 13.9%, with a mean follow-up of 55.1 ± 28.7 months. Higher average systolic blood pressure was associated with a higher risk of ED in a dose-dependent manner (trend test, P < .001). Wide variation in blood pressure control was associated with a higher incidence of ED (OR [95% CI]; 1.359 [1.258-1.469]) and a shorter time to the development of ED (log rank, P < .0001). CLINICAL IMPLICATIONS: We believe these data may serve as a motivator for hypertensive men to better adhere to their hypertension treatment regimen. STRENGTH & LIMITATIONS: The retrospective nature of our study precludes us from drawing more than an association between tighter blood pressure control and ED. Strengths of our study include the large sample size, community cohort, and completeness of follow-up. CONCLUSION: Among adults diagnosed with hypertension, tighter blood pressure control, as measured by average systolic blood pressure and deviation from the average, is associated with a lower incidence and a longer time to the development of ED. Hsiao W, Bertsch RA, Hung Y-Y, et al. Tighter Blood Pressure Control Is Associated with Lower Incidence of Erectile Dysfunction in Hypertensive Men. J Sex Med 2019;16:410-417.

Impaired HPA axis function in diabetes involves adrenal apoptosis and phagocytosis.

PURPOSE: The aim of the present study was to analyze the involvement of oxidative stress and inflammation in the modulation of glucocorticoid production in the adrenal cortex of diabetic rats. METHODS: Male Wistar rats were treated with or without streptozotocin (STZ, an insulinopenic model of diabetes) and either α-lipoic (90 mg/kg ip.), α-tocopherol (200 mg/kg po.) or with STZ and supplemented with insulin (STZ + INS: 2.5U/day) for 4 weeks. Oxidative/nitrosative stress parameters and antioxidant enzymes were determined in adrenocortical tissues. Apoptosis and macrophage activation were evaluated by immunohistochemistry (TUNEL and ED1+). Basal and ACTH-stimulated corticosterone production were assessed by RIA and plasma ACTH levels were determined by an immunometric assay. RESULTS: Diabetic rats showed a diminished response to exogenous ACTH stimulation along with higher basal corticosterone and lower plasma ACTH levels. In the adrenal cortex we determined an increase in the levels of lipoperoxides, S-nitrosothiols, nitric oxide synthase activity and nitro-tyrosine modified proteins while catalase activity and heme oxygenase-1 expression levels were also elevated. Antioxidant treatments were effective in the prevention of these effects, and in the increase in the number of apoptotic and phagocytic (ED1+) cells detected in diabetic rats. No changes were observed in the STZ + INS group. CONCLUSIONS: Generation of oxidative/nitrosative stress in the adrenal cortex of diabetic rats leads to the induction of apoptosis and the activation of adrenocortical macrophages and is associated with an elevated basal corticosteronemia and the loss of the functional capacity of the gland.

Thyroid Dysfunction and Anemia: A Prospective Cohort Study and a Systematic Review.

BACKGROUND: Even though the association between thyroid dysfunction and anemia is commonly described, it is not known whether it is clinically relevant. This study set out to quantify the association of thyroid dysfunction on hemoglobin (Hb) concentration and risk of anemia. A systematic review (MEDLINE and EMBASE, from inception until May 15, 2017) was conducted to interpret the findings in context. METHODS: Participants from the EPIC-Norfolk cohort with available baseline thyrotropin (TSH), free thyroxine (fT4), and Hb were included. Euthyroidism was defined as TSH 0.45-4.49 mIU/L (reference category), hypothyroidism as TSH ≥4.50 mIU/L (subclinical [SHypo] with normal fT4 or overt [OHypo] with low fT4), and hyperthyroidism as TSH ≤0.44 mIU/L (subclinical [SHyper] with normal fT4 or overt [OHyper] with elevated fT4). Anemia was defined as Hb <12 g/dL in women and Hb <13 g/dL in men. In the cross-sectional analyses, multiple linear regression was used to compare Hb across TSH categories. In the prospective analysis, participants with OHypo/OHyper at baseline were excluded, as it was assumed that they were treated for overt thyroid disease. A covariance model was used to determine change in Hb concentration from baseline to last follow-up, and multivariable Cox regression was used to analyze anemia risk. RESULTS: In the cross-sectional population (n = 12,337), the adjusted Hb was 0.22 g/dL lower [confidence interval (CI) 0.07-0.38] in OHypo compared to euthyroids, and 0.08 g/dL lower [CI -0.23 to 0.38] in OHyper. In the prospective analysis, 460/7031 participants developed anemia over a median follow-up of 4.7 years. The adjusted mean Hb change over time was -0.04 g/dL in SHypo [CI -0.14 to 0.06] and 0.05 g/dL in SHyper [CI -0.10 to 0.20]. The adjusted hazard ratio for anemia was 0.99 [CI 0.67-1.48] in SHypo, and 0.52 [CI 0.23-1.16] in SHyper. The systematic review returned no other prospective studies on this association, but cross-sectional and case-control studies showed comparable results. CONCLUSION: In this first prospective population-based cohort, subclinical thyroid dysfunction was not associated with a change in Hb concentration during follow-up and was not an independent risk factor for developing anemia; variations in Hb concentration in patients with overt thyroid dysfunction were not clinically relevant.

Protective Effects of Curcumin on Manganese-Induced BV-2 Microglial Cell Death.

Curcumin, a bioactive component in tumeric, has been shown to exert antioxidant, anti-inflammatory, anticarcinogenic, hepatoprotective, and neuroprotective effects, but the effects of curcumin against manganese (Mn)-mediated neurotoxicity have not been studied. This study examined the protective effects of curcumin on Mn-induced cytotoxicity in BV-2 microglial cells. Curcumin (0.1-10 µM) dose-dependently prevented Mn (250 µM)-induced cell death. Mn-induced mitochondria-related apoptotic characteristics, such as caspase-3 and -9 activation, cytochrome c release, Bax increase, and Bcl-2 decrease, were significantly suppressed by curcumin. In addition, curcumin significantly increased intracellular glutathione (GSH) and moderately potentiated superoxide dismutase (SOD), both which were diminished by Mn treatment. Curcumin pretreatment effectively suppressed Mn-induced upregulation of malondialdehyde (MDA), total reactive oxygen species (ROS). Moreover, curcumin markedly inhibited the Mn-induced mitochondrial membrane potential (MMP) loss. Furthermore, curcumin was able to induce heme oxygenase (HO)-1 expression. Curcumin-mediated inhibition of ROS, down-regulation of caspases, restoration of MMP, and recovery of cell viability were partially reversed by HO-1 inhibitor (SnPP). These results suggest the first evidence that curcumin can prevent Mn-induced microglial cell death through the induction of HO-1 and regulation of oxidative stress, mitochondrial dysfunction, and apoptotic events.

Prognostic Importance of Diastolic Dysfunction in Relation to Post Procedural Aortic Insufficiency in Patients Undergoing Transcatheter Aortic Valve Replacement.

OBJECTIVES: We sought to examine whether baseline diastolic dysfunction (DD) is associated with increased mortality in patients who develop aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Significant post-TAVR AI is associated with increased mortality, likely secondary to adverse hemodynamics secondary to volume overload and decreased LV compliance from chronic pressure overload. However, the effect of baseline DD on outcomes of patients with post-TAVR AI has not been studied. METHODS: A total of 195 patients undergoing TAVR were included in the study. Patients with moderate-to-severe mitral stenosis, prior mitral valve replacement or atrial fibrillation were excluded. DD was classified at baseline by a 2-step approach as recommended by the American Society of Echocardiography while AI was evaluated 30 days post-TAVR. Follow up data up to 2 years post-TAVR was used in survival analysis. RESULTS: Patients with severe baseline DD who developed ≥mild post-TAVR AI had increased mortality compared to all other patients (HR = 3.89, CI: 1.76-8.6, P = 0.001), which remained significant after adjusting for post-TAVR AI, pre-TAVR AI, baseline mitral regurgitation, ejection fraction, pulmonary artery pressure, creatinine clearance and history of stroke. CONCLUSIONS: Even mild post-TAVR AI may have a negative impact on outcomes of patients with underlying severe DD. © 2016 Wiley Periodicals, Inc.

Cardio-renal syndrome.

Cardio-renal syndrome is a commonly encountered problem in clinical practice. Its pathogenesis is not fully understood. The purpose of this article is to highlight the interaction between the cardiovascular system and the renal system and how their interaction results in the complex syndrome of cardio-renal dysfunction. Additionally, we outline the available therapeutic strategies to manage this complex syndrome.

Prevalência da disfunção temporomandibular e qualidade de vida em acadêmicos de Fisioterapia / Temporomandibular dysfunction prevalence and quality of life in Physiotherapy academics

Objetivo ­ Analisar a prevalência dos graus de disfunções temporomandibulares e relacioná-los com a qualidade de vida (QDV) em acadêmicos de Fisioterapia. Métodos ­ Estudo de natureza transversal, quantitativa e exploratória. O grau de DTM e a perspectiva de QDV foram avaliados através do Índice Anamnésico de Fonseca e o Questionário de Qualidade de Vida SF-36, em 732 voluntários acadêmicos e ambos os gêneros. As comparações foram realizadas pelos testes Qui-quadrado de Pearson ou Exato de Fisher, além de outros testes para correlação e precisão dos dados, nos quais foram analisados com o IBM SPSS Statistics versão 2.0 e consideradas diferenças estatisticamente significativas com intervalo de confiança de 95% (p <0,05). Resultados ­ Foi estimado uma prevalência maior para os graus de DTM no gênero feminino e os resultados apontaram que as estudantes apresentaram um risco de 2,6 vezes mais elevado para DTM leve, 3,97 para DTM moderado, e um risco de 5,88 maior para DTM severo quando comparadas ao sexo opos to e que em ambos os gêneros se verificou que quanto mais elevado o grau de DTM, menor a qualidade de vida. Conclusão ­ Con clui-se que com esta amostra as mulheres são mais acometidas pela sintomatologia das DTMs e pode-se afirmar que a QDV é inversamente proporcional ao nível de DTM.

Objective ­ To assess the prevalence of degree of temporomandibular disorders and relate them to the quallity of life (QOL) in Physiotherapy academics. Methods ­ Study transversal, quantitative and exploratory. The degree of DTM and the prospect of QOL were assessed through the Fonseca Anamnesic Index and the Quality of Life Questionnaire SF-36 academic volunteers of both genders. Comparisons were performed by Chi-squared tests or Fisher's exact, and other tests for correlation and accurate data, in which were analyzed with the IBM SPSS Statistics version 2.0 and consideres statistically significant differences at the 95% confidence interval (p<0.05). Results ­ We estimated a higher prevalence for grades of TMD in females and the results showed that the students had a risk 2.6 times higher for light DTM, 3.97 for moderate TMD, and a risk of 5.88 DTM for more severe when compared to the opposite sex and in both gender was found that the higher the level of TMD, the lower the quality of life. Conclusion ­ We conclude with this sample that women are more affected by symptoms of TMD and can state that WOL is inversely proportional to the level of TMD.

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health.

PURPOSE: There is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men. MATERIALS AND METHODS: A total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed. RESULTS: By use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction. CONCLUSIONS: Our data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.

Cardiotoxicity of molecular-targeted drug therapy.

Cardiotoxicity is a well-known side-effect described in patients receiving various antineoplastic agents. With the abundance of clinical research and a heavy focus on drug development over the past decade, there has been a major shift in the use of non-specific cytotoxic drugs to molecular-targeted drug therapy. However, as a result, it has become clear that these drugs have numerous adverse effects, both on-target and off-target. Small-molecule tyrosine kinase inhibitors and other molecular-targeted agents, including monoclonal antibodies, have been the primary agents associated with cardiotoxicity. As more molecular-targeted therapies are developed, early recognition and management of drug-related cardiotoxicity will be extremely important in order to reduce morbidity and mortality. Pre-treatment evaluation with a surface electrocardiogram, echocardiography, cardiac history, and comprehensive review of concomitant medications are the current mainstay of treatment. However, much is still unknown about the potential cardiotoxic side-effects of these drug and optimal management. In the present article, we aim to review the cardiovascular implications and related cardiotoxicities associated with molecular target-based chemotherapeutic agents, with special emphasis on hypertension, cardiac dysfunction, and QT prolongation. Their implication, mechanism, and management are discussed where possible.