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1.
Stress Health ; 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38059671

RESUMEN

Numerous studies have found that the COVID-19 epidemic and the measures to stop it have had a substantial impact on the mental health of the general population. Nevertheless, the majority of this research only looked at the variations in the degree of psychopathological symptoms in individuals before and after the first wave of the pandemic. In a sample of N = 380 preschoolers and their mothers assessed through the Symptom Check-List/90-R and of the Child Behaviour Check-List, the present study aimed at exploring psychopathological risk in mothers and their offspring's dysregulation levels before (T1), during (T2) and after (T3) the peak of COVID-19 pandemic. Our main results showed that mothers' relational distress increased from T1 to T2 and then increased again from T2 to T3. Moreover, maternal aggressiveness, hostility, and anxiety scores significantly decreased from T1 to T2 but slightly increased from T2 to T3. In children, dysregulation levels increased from T1 to T2 but decreased from T2 to T3. Children of mothers with clinical scores at the SCL-90/R showed significantly higher dysregulation problems at T1, T2 and T3 than children of mothers with scores below the clinical threshold. This study adds to previous literature in that it evaluates stability or change in maternal and offspring scores not only in the pre-pandemic period and during the first wave of the pandemic, but it also considers the subsequent months, focusing on a broad range of maternal symptoms, rather than assessing depressive and anxiety symptoms as most of previous research did.

2.
Infant Behav Dev ; 73: 101892, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37839158

RESUMEN

During the second year of life, children's need for autonomy grows, and their behaviors become increasingly complex. Parental sensitivity to children's different cues is important in supporting adaptive psycho-emotional development. The present study assumes that mothers and fathers may respond with varying levels of sensitivity to the child's different cues, with particular attention to requests for greater autonomy. The study also examines the possible role played by interactive contexts (ie., play and feeding) and children's and parents' individual factors. The sample comprised N = 91 families with children aged between 12 and 24 months. Mother-toddler and father-toddler interactions were assessed during feeding and play. Parents completed questionnaires assessing children's temperament, psychopathological risk, and parenting stress. RESULTS: showed that toddlers' demands for autonomy were the most frequent cues in both play and feeding contexts, both with mothers and fathers. Furthermore, parents were more sensitive to toddlers' requests for cooperation than their requests for autonomy, in both interactive contexts. Moreover, mothers and fathers showed higher sensitivity to toddlers' demands for greater autonomy in the play context rather than in the feeding context. Mothers were more sensitive than fathers to toddlers' cues of resistance to parents' actions and to toddlers' requests for cooperation. Results showed differences and specificities in mother-toddler and father-toddler interactions in the two interactive contexts, showing associations between child negative emotionality, parental psychopathological risk and parenting stress, and maternal and paternal sensitivity to toddlers' demands for greater autonomy during play and feeding, respectively. These results confirm the initial hypotheses regarding parental sensitivity and its differential expression according to child cues. Implications are discussed.


Asunto(s)
Madres , Padres , Masculino , Femenino , Humanos , Preescolar , Lactante , Madres/psicología , Padres/psicología , Padre/psicología , Emociones , Responsabilidad Parental/psicología
4.
Heliyon ; 8(12): e12489, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36568660

RESUMEN

Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative review has searched the scientific literature in the field focusing on children. A non-systematic literature review was conducted in May 2022. Various databases were employed to conduct the document research for this paper, such as "Google Scholar", "PubMed", "Web of Science". Keywords for the search included "screen time", "media", "digital use", "social media", "COVID-19", "pandemic", "lockdown", "children", "effect of media on children during COVID". It was found that both children and adolescents seem to have used technologies to confront struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media use can have positive effects on children depending on usage and monitoring by the parents.

5.
Assist Technol ; 34(5): 527-532, 2022 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-33481693

RESUMEN

Severe neurodegenerative diseases such as Parkinson's disease or multiple sclerosis and acute events like stroke, spinal cord injuries, or other related pathologies have been shown to negatively impact the central and peripheral nervous systems, thus causing severe impairments to mobility. The development and utilization of exoskeletons as rehabilitation devices have shown good potential for improving patients' gait function. Ten older adults (age: 68.9 ± 9.2 yrs; height: 1.65 ± 0.08 m; mass: 71.6 ± 11.0 kg) affected by neurological diseases impacting their gait function completed a 10-session gait training protocol where they walked for 10 minutes wearing a passive exoskeleton assisting hip flexion, namely, Exoband. Results showed that participants walked a significantly longer distance in the last session of training with respect to the first session (453.1 ± 178.8 m vs 392.4 ± 135.1 m, respectively). This study indicates the potential of Exoband as an effective tool for gait rehabilitation in patients with neurological diseases. Wearable, lightweight, and low-cost devices such as the one involved in this work have the potential to improve walking distance in patients.


Asunto(s)
Dispositivo Exoesqueleto , Trastornos Neurológicos de la Marcha , Rehabilitación de Accidente Cerebrovascular , Anciano , Marcha , Trastornos Neurológicos de la Marcha/rehabilitación , Humanos , Persona de Mediana Edad , Rehabilitación de Accidente Cerebrovascular/métodos , Caminata/fisiología
6.
Child Psychiatry Hum Dev ; 52(2): 281-290, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32462358

RESUMEN

The role of the dopamine transporter (DAT) in the onset and maintenance of emotional-behavioral difficulties is recognized in adults, adolescents and school-age children, whereas few studies in this field have focused on preschoolers. The study recruited 2-year old children (N = 152) in the general population assessing the possible effect of DAT methylation and allelic polymorphism on internalizing and externalizing symptoms, also exploring whether epigenetic and genetic variability interact. Our results showed that DAT methylation is significantly associated with all the dimensions of children's emotional/behavioral functioning in children carrying 10/10-3/3-8/10 polymorphisms but not in children carrying 9/10-9/9 allele repeats. Understanding the influence of genetic/epigenetic factors on maladaptive emotional/behavioral outcomes in young children, can be of great help in programming effective prevention and intervention plans and can be a valid aid to alleviate psychopathological symptoms before they crystalize into more severe clinical conditions in later life.


Asunto(s)
Metilación de ADN , Emociones , Polimorfismo Genético , Alelos , Preescolar , Mecanismos de Defensa , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática/genética , Femenino , Humanos , Masculino
7.
BMC Psychol ; 8(1): 126, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33261655

RESUMEN

BACKGROUND: Maternal sub-threshold and non-clinical depression and its possible outcomes on offspring internalizing/externalizing symptoms has received growing attention in recent years because of its significant worldwide prevalence. METHODS: Through a Latent State-Trait Analysis approach (LST), this longitudinal study aimed to identify a stable component of non-clinical maternal depression across a temporal interval of 6 years (measured through the Symptom Check-List-90/R) and to determine the effect of this component on children's emotional and behavioral functioning (measured through the Child Behaviour Check-List) at age 12 years. RESULTS: LST analysis showed that maternal depressive symptoms tended to remain stable within individuals across 6 years of observation strongly contributing to children's internalizing/externalizing and dysregulation symptoms. CONCLUSIONS: The current longitudinal analysis of maternal and child data revealed that a stable component of maternal depressive symptoms reliably predicted a wide range of child emotional and behavioral symptoms at 12 years of age.


Asunto(s)
Depresión/epidemiología , Emociones , Control Interno-Externo , Madres/psicología , Madres/estadística & datos numéricos , Psicología Infantil , Niño , Preescolar , Familia/psicología , Femenino , Humanos , Estudios Longitudinales
8.
Int J Cardiol ; 299: 271-275, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31422879

RESUMEN

AIMS: Cardiovascular disease is a well-recognized cause of increased late morbidity and mortality among survivors of childhood cancer treated with anthracyclines. Co-administration of Dexrazoxane has been shown to significantly reduce short-term and mid-term cardiotoxicity. Aim of this study was to assess cardiac function in long-term (>10 years) survivors of childhood tumors treated with dexrazoxane/anthracycline association. METHODS AND RESULTS: Twenty cancer survivors previously treated with co-administration of anthracyclines-dexrazoxane for childhood renal tumors or sarcoma and a control group of 20 healthy subjects were enrolled in the study. Echocardiographic measurements included 3D left ventricular (LV) ejection fraction (LVEF) and LV and right ventricular (RV) global longitudinal strain (GLS). Among cancer survivors group the median age at diagnosis was 5 years (1-17) and they were evaluated at median follow-up time of 21.5 years (10-26). No evidence of cardiac toxicity, as defined by current guidelines, was reported in all survivors. No significant differences in standard and deformation imaging parameters were observed between survivors and controls (3D LVEF 58 ±â€¯3% vs 60 ±â€¯5% p = NS; LV GLS -21 ±â€¯1% vs -21 ±â€¯2% p = NS; RV GLS -23 ±â€¯2% vs -23 ±â€¯5% p = NS). No second tumor was registered in dexrazoxane-treated survivors. CONCLUSIONS: Our findings may support the role of dexrazoxane as a useful strategy for cardio-protection in children undergoing anthracycline based treatment. However, large randomized trials are needed to confirm the cardio-protective role of dexrazoxane in pediatric setting at long-term follow-up.


Asunto(s)
Antraciclinas/administración & dosificación , Antineoplásicos/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Supervivientes de Cáncer , Dexrazoxano/administración & dosificación , Ecocardiografía/tendencias , Adulto , Ecocardiografía/efectos de los fármacos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
9.
J Endocrinol Invest ; 42(12): 1459-1465, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31165424

RESUMEN

BACKGROUND: Papillomavirus (HPV) often occurs in the semen of patients with male accessory gland infection (MAGI). Ultrasound (US) evaluation has been suggested as a promising diagnostic tool for patients with HPV-related MAGI. No data on the spontaneous clearance of HPV-DNA have been reported so far in HPV-related MAGI. PURPOSE: The primary aim of the study was to assess the percentage of early HPV-DNA spontaneous clearance in patients with prostatitis. The secondary aim was to evaluate the frequency of spontaneous clearance of HPV-DNA among patients with prostatitis associated with the presence or absence of US abnormalities. METHODS: Patients with inflammatory MAGI and at least one suspicious criterion for HPV infection underwent semen HPV-DNA detection and prostate US. The presence of HPV-DNA was further investigated after a 6-month-long follow-up. MAIN RESULTS: Eighty patients satisfied the inclusion criteria and were recruited in the study. 69% of patients (55/80) showed HPV-DNA persistence in the semen. Among them, 82% (45/55) was positive for US signs of prostatitis, while they occurred only in 12% (3/25) of those patients with no sign of HPV-DNA persistence (p < 0.001). All patients with persistent high-risk HPV genotype (n = 30) showed at least two US signs of prostatitis. In 73% of patients (22/30), E6 and E7 mRNAs were detected. CONCLUSION: US signs of prostatitis more frequently occurred in patients with evidence of HPV-DNA persistence on semen, especially in those with high-risk genotypes. This highlights the importance of US in the framework of HPV-related MAGI.


Asunto(s)
Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Infecciones por Papillomavirus/diagnóstico por imagen , Prostatitis/diagnóstico por imagen , Adulto , Enfermedades de los Genitales Masculinos/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/complicaciones , Análisis de Semen , Ultrasonografía , Adulto Joven
10.
Can Prosthet Orthot J ; 2(1): 31950, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-37614808

RESUMEN

BACKGROUND: The majority of lower limb amputations (LLA) in Canada are dysvascular due to complications of diabetes and/or vascular disease. Traditionally dysvascular amputations have occurred in the elderly. With younger onset of adult diabetes, amputations are now occurring in non-geriatric populations. An understanding of younger patients with dysvascular LLA is needed to determine their risk factors, and unique health and psychosocial challenges. OBJECTIVES: To obtain a depiction of the key demographic and impairment characteristics of adults 65 years and younger with dysvascular LLA undergoing inpatient rehabilitation. METHODOLOGY: A retrospective chart review was completed on inpatient adult amputation rehabilitation patients over a five year period. Data extracted included socio-demographics, Functional Independence Measure (FIM) scores, comorbidities, and discharge outcomes. FINDINGS: One hundred and forty-three patients who were 65 years and younger were included, which represented almost a quarter of all admissions. Most patients were male (79%) with an average age of 55 years old (SD=8). The majority (72%) were unemployed. The mean number of co-morbidities was 5.2 (SD=8.2). Individuals discharged home (n=122) had higher (p<0.05) FIM scores than those readmitted to acute care or discharged to long-term care (n=20). CONCLUSIONS: Similar to the literature on older dysvascular LLA patients, our study found high rates of disability and co-morbidities in younger patients with dysvascular LLA, which might impact their ability to work. Given these challenges, better amputation prevention strategies and targeted rehabilitation programming for this population are needed.

11.
Andrology ; 6(5): 737-741, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29858538

RESUMEN

Some evidences have supported the link between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and inflammation. In this study, we aimed to evaluate the association between prostatic inflammation (PI) and non-alcoholic steatohepatitis (NASH) evaluated by a non-invasive scores in a cohort of patients affected by BPH/LUTS. Between January 2012 and January 2016, we conducted a prospective study in a single academic outpatient clinic on 132 consecutive patients who underwent surgery for lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO). A non-invasive non-alcoholic steatohepatitis score (NASH score) was calculated, and PI was evaluated through the Irani score. Patients with a NASH score > 1.05 had an average larger prostate volume (55 vs. 45 cc, p < 0.05), a greater waist circumference (103 vs. 93.5 cm, p < 0.01), and high values of blood glucose, triglycerides, insulin, and BMI compared to patients without NASH; 36% of patients with an Irani score ≥ 4 had NASH compared to 16.1% of patients who had a NASH score < 1.05 (p < 0.05). We found that non-alcoholic steatohepatitis (NASH ≥ 1.05) was an independent risk factor for Irani score ≥4 (OR: 3.24; p < 0.05) and of prostate volume ≥ 40 cc (OR: 13.99; p < 0.01). LUTS/BPH and NASH can be closely related, underlying common triggers of induction. In particular, inflammation seems to be associated with both conditions and with prostate gland overgrowth. Early identification of this class of patients could play a key role in preventing complications related to disease progression.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico/complicaciones , Hiperplasia Prostática/complicaciones , Prostatitis/complicaciones , Anciano , Estudios de Cohortes , Progresión de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Obstrucción del Cuello de la Vejiga Urinaria/complicaciones , Obstrucción del Cuello de la Vejiga Urinaria/cirugía
12.
RSC Adv ; 8(45): 25846-25855, 2018 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-35539807

RESUMEN

Ni- and Ru-based catalytic pellets supported on commercial γ-Al2O3 pellets modified with magnesium oxide have been prepared for application in the catalytic conversion of ethanol into butanol. MgO/γ-Al2O3 pellets with or without added metals have been characterized by XRD, SEM/EDX, TGA, N2 physisorption, H2 TPR, and CO2 TPD in order to investigate the effect of MgO coverage and metal distribution on the surface and red-ox properties of the materials and, in turn, their effects on the catalytic performance. The conversion of ethanol into butanol has been investigated in a continuous flow reactor at 350-400 °C under diluted conditions (3% ethanol) in order to rank the different catalytic pellets and identify the best formulations and preparation procedures via a comparison with powder catalysts previously proposed in the literature with similar compositions. Results show enhanced catalytic performance for MgO-covered alumina pellets with respect to a pure MgO powder catalyst in spite of the lower MgO load. A significant further positive effect is found when Ni or Ru enters a solid solution with MgO.

13.
Int J Impot Res ; 29(6): 240-243, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28814812

RESUMEN

The surgical treatment of benign prostatic obstruction is changing over the time, thanks the increase evidence about the successful role of laser techniques in this surgery. We aimed to compare prostatic GreenLight photovaporization (PVP) to bipolar transurethral resection of the prostate (TURP) with regard to lower urinary tract symptoms (LUTS) improvement through the evaluation of BPH6. We enrolled 220 consecutive subjects affected by LUTS. We performed a propensity score matching using prostate volume, peak flow and International Prostate Symptoms Score (IPSS). A total of 110 (55 TURP and 55 PVP) were analyzed. We found after 1 year of follow-up that the rate of subjects resulting in greater BPH6 recovery in the PVP group vs TURP (45.6% vs 18.2%; P=0.001). The TURP treatment showed greater catheterization time (4.67 vs 1.25; P<0.01) while PVP showed greater recovery experience (82.4 vs 58.2; <0.01). Postoperative ejaculatory dysfunctions were observed in both groups, 58.8% in TURP and 34.5% in PVP group. The multivariate logistic regression analysis, adjusted for preoperative variables, showed that PVP was independently associated with BPH6 recovery end point (odds ratio=3.77; P<0.01). This study showed data in favor of PVP. Although IPSS and peak flow improvements were similar, PVP showed better clinical outcomes.


Asunto(s)
Terapia por Láser/métodos , Próstata/cirugía , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Anciano , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
14.
Andrology ; 5(4): 771-775, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28718527

RESUMEN

Several intralesional therapeutic protocols have been proposed for the treatment of Peyronie's disease. Among all, hyaluronic acid (HA) and verapamil have been differently tested. We aimed to evaluate the efficacy of intralesional verapamil (ILVI) compared with intralesional HA in patients with early onset of Peyronie's disease (PD). This is a multi-centre prospective double-arm, randomized, double-blinded study comparing ILVI vs. intralesional HA after 12-weeks. Sexually active men, older than 18 years and affected by the acute phase of PD were eligible for this study. Patients have been double-blinded randomly divided into two groups (1 : 1 ratio): Group A received intralesional treatment with Verapamil (10 mg in 5 mL of normal saline water) weekly for 12 weeks, while group B received intralesional treatment with HA (0.8% highly purified sodium salt HA 16 mg/2 mL) weekly for 12 weeks. The primary efficacy outcome was the change from the baseline to the endpoint (12 weeks after therapy) for the penile curvature (degree). The secondary outcome was the change in the plaque size and in the International Index of erectile Function (IIEF-5) score. The difference between post- and pre-treatment plaque size was -1.36 mm (SD ± 1.27) for Group A and -1.80 mm (SD ± 2.47) for Group B (p-value = NS). IIEF-5 increased of 1.46 points (SD ± 2.18) in Group A and 1.78 (SD ± 2.48) in Group B (p-value ± NS). No difference in penile curvature was observed in Group A, while in Group B the penile curvature decreased of 4.60° (SD ± 5.63) from the baseline (p < 0.001) and vs. Group A. According to PGI-I results, we found significant difference as concerning patient global impression of improvement (PGI-I) (4.0 vs. 2.0; p < 0.05). This prospective, double-arm, randomized, double-blinded study comparing ILVI vs. HA as intralesional therapy showed greater efficacy of HA in terms of penile curvature and PGI-I.


Asunto(s)
Ácido Hialurónico/administración & dosificación , Induración Peniana/tratamiento farmacológico , Pene/efectos de los fármacos , Agentes Urológicos/administración & dosificación , Verapamilo/administración & dosificación , Adulto , Anciano , Método Doble Ciego , Humanos , Ácido Hialurónico/efectos adversos , Inyecciones Intralesiones , Italia , Masculino , Persona de Mediana Edad , Erección Peniana/efectos de los fármacos , Induración Peniana/diagnóstico , Induración Peniana/fisiopatología , Pene/patología , Pene/fisiopatología , Estudios Prospectivos , Recuperación de la Función , Factores de Tiempo , Resultado del Tratamiento , Agentes Urológicos/efectos adversos , Verapamilo/efectos adversos
15.
Neurosci Biobehav Rev ; 76(Pt A): 174-184, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28027952

RESUMEN

Despite it has not been formally included in DSM-5 as a disorder, 'Internet addiction (IA)' has become a worldwide issue. It can be broadly defined as a non-chemical, behavioral addiction, which involves human-machine interaction. We pinpoint it as an "instrumental" form of social interaction (i.e. mediated by machines), a notion that appears useful for the sake of possible preclinical modeling. The features of Internet use reveals as addictive when this comes at the expense of genuine real-life sociability, with an overlap towards the hikikomori phenomenon (i.e., extreme retreat to one's own room). Due to the specific neuro-developmental plasticity in adolescence, IA poses risks to youths' mental health, and may likely produce negative consequences in everyday life. The thwarted development of adolescents' identity, self-image and adaptive social relationships is discussed: the IA adolescents often suffer loss of control, feelings of anger, symptoms of distress, social withdrawal, and familial conflicts. Further, more severe clinical conditions are also associated to IA, such as dysthymic, bipolar, affective, social-anxiety disorders, as well as major depression. This paper overviews the literature on IA, from neuro-biological, psycho-social and clinical standpoints, taking into account recent debates on diagnostic criteria, nosographic label and assessment tools. Neuroimaging data and neurochemical regulations are illustrated with links to pathogenetic hypotheses, which are amenable to validation through innovative preclinical modeling.


Asunto(s)
Conducta del Adolescente , Conducta Adictiva , Adolescente , Trastorno Depresivo Mayor , Humanos , Internet
16.
Skin Res Technol ; 22(3): 263-75, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26333046

RESUMEN

BACKGROUND: The clinical use of non-invasive instrumentation to evaluate skin characteristics for diagnostic purposes and to evaluate treatment outcomes has become more prevalent. The purpose of this study was to generate normative data for skin elasticity, erythema (vascularity), melanin (pigmentation), and thickness across a broad age range at a wide variety of anatomical locations using the Cutometer(®) (6 mm probe), Mexameter(®) , and high-frequency ultrasound in a healthy adult sample. METHODS: We measured skin characteristics of 241 healthy participants who were stratified according to age and gender. Sixteen different anatomical locations were measured using the Cutometer(®) for maximum skin deformation, gross elasticity, and biological elasticity, the Mexameter(®) for erythema and melanin, and high-frequency ultrasound for skin thickness. Standardized measurement procedures were applied for all participants. RESULTS: The means and standard deviations for each measured skin characteristic for females and males across five different age groups (20-29, 30-39, 40-49, 50-59, 60-69, and 70-85 years old) are presented. As previously described, there were variations in skin characteristics across age groups, anatomical locations, and between females and males highlighting the need to use site specific, age and gender matched data when comparing skin characteristics. CONCLUSION: The reported data provides normative data stratified by anatomical location, age, and gender that can be used by clinicians and researchers to objectively determine whether patients' skin characteristics vary significantly from healthy subjects.


Asunto(s)
Envejecimiento/fisiología , Módulo de Elasticidad/fisiología , Eritema/fisiopatología , Melaninas/metabolismo , Fenómenos Fisiológicos de la Piel , Piel/anatomía & histología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/patología , Simulación por Computador , Eritema/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Caracteres Sexuales
17.
Int J Impot Res ; 27(6): 201-5, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26224573

RESUMEN

To address the severity of erectile dysfunction (ED) in consecutive sexually active men seeking a prostate health screening through a multivariable risk stratification including comorbidities and lower urinary tract symptoms (LUTS). Four hundred and twenty five consecutive subjects with stable sexual relationship with normal testosterone levels were enrolled. The International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires were collected and health-significant comorbidities were scored with the Charlson comorbidity index (CCI). All the independent predictors of ED were combined to form four different risk categories of ED: low (age⩽65 years and IPSS<8 and CCI=0), intermediate (one of the following: age>65 years, IPSS⩾8 or CCI⩾1), high (two of the following: age>65 years, IPSS⩾8 or CCI⩾1) and very high (age >65 years, IPSS⩾8 and CCI⩾1). The prevalence of ED increased with increase of CCI (χ(2) likelihood ratio: 40.85, P=0.001). The median of the IIEF-5 significantly reduced with the increase of the CCI (P<0.001) and with the worsening of our risk group stratification (P<0.001). At univariate logistic regression analysis very high risk was significantly associated with of ED (odds ratio: 26.85, P<0.001). Very high-risk group predicted ED with 88% and 56% of specificity and sensitivity, respectively. Combining these risk factors through our risk stratification may be usefulness in revealing an underling ED.


Asunto(s)
Disfunción Eréctil/diagnóstico , Próstata , Salud Reproductiva , Anciano , Diabetes Mellitus/epidemiología , Disfunción Eréctil/epidemiología , Disfunción Eréctil/fisiopatología , Humanos , Hiperlipidemias/epidemiología , Hipertensión/epidemiología , Síntomas del Sistema Urinario Inferior , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Oportunidad Relativa , Factores de Riesgo , Encuestas y Cuestionarios , Testosterona/sangre
18.
Prostate Cancer Prostatic Dis ; 18(4): 338-42, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26032650

RESUMEN

BACKGROUND: To assess the added value of biopsy factors, like maximum cancer length in a core (MCL), cumulative cancer length (CCL), cumulative length of positive cores (CLPC), percentage of cancer involvement in positive cores (CIPC) and the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria in patients who underwent radical prostatectomy (RP) but eligible for active surveillance (AS). METHODS: From January 2002 to December 2007, 750 consecutive subjects underwent RP. We identified 147 (19.07%) patients who were eligible for AS based on PRIAS criteria: clinical stage T1c or T2, PSA level of ⩽ 10 ng ml(-1), Gleason score ⩽ 6, PSA-D of <0.2 ng ml(-2) and one or two positive biopsy cores. We calculated the diagnostic accuracy of biopsy factors in determining pathological confirmed unfavorable disease. Decision curve analysis (DCA) were performed. RESULTS: Of all subjects, 95 patients (66.43%) had favorable whereas 48 had (33.57%) unfavorable disease. On multivariate analyses, the inclusion of MCL, CCL, CLPC and CIPC significantly increased the accuracy of the base multivariate model in predicting unfavorable disease. The gain in predictive accuracy for MCL in a core, CCL, CLPC and CIPC ranged from 13 to 27%. The DCA shows that adding MCL, CCL, CLPC and CIPC resulted in a greater net benefit when the probability of ranges between 15 and 50%. The models can be applied at the cost of missing not more than 16.83% of unfavorable disease. CONCLUSIONS: Our findings suggested that the addition of these biopsy factors to PRIAS criteria has the potential to significantly increase the ability to detect unfavorable disease.


Asunto(s)
Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Anciano , Biomarcadores de Tumor , Biopsia , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Vigilancia de la Población , Pronóstico , Antígeno Prostático Específico/sangre , Prostatectomía/métodos , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/cirugía , Curva ROC , Reproducibilidad de los Resultados
19.
Int J Immunopathol Pharmacol ; 28(1): 85-92, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25816410

RESUMEN

The aim of this study was to evaluate the concentrations of CD45pos leukocytes in the semen samples of infertile patients with low testicular volume (TV) compared to subjects with normal TV. The testis was considered normal in size when it had a volume between 15 and 25 cm(3), low-normal with a volume between 10 and 12 cm(3) and hypotrophic when the volume was <10 cm(3). The patients with low testicular volume (<10 cm(3)) showed significantly higher concentrations of CD45pos leukocytes compared to other groups (P <0.05). The correlation analysis showed the presence of a positive linear relationship between CD45pos leukocytes and the percentage of immature germ elements (r = 0.88; P <0.05) and between CD45pos leukocytes and the percentage of spermatozoa with phosphatidylserine externalisation (r = 0.90; P <0.05) as well as a negative linear relationship between the percentage of spermatozoa with normal morphology and the seminal CD45pos leukocyte concentrations ( r = -0.75; P <0.05). The results of this study showed that patients with low testicular volume (<10 cm(3)) have significantly increased CD45pos leukocyte concentrations associated with increased percentages of immature germ elements, spermatozoa with signs of early apoptosis and spermatozoa with abnormal morphology.


Asunto(s)
Antígenos Comunes de Leucocito/metabolismo , Leucocitos/metabolismo , Semen/metabolismo , Testículo/metabolismo , Adulto , Apoptosis/fisiología , Humanos , Masculino , Persona de Mediana Edad , Motilidad Espermática/fisiología , Espermatozoides/metabolismo , Adulto Joven
20.
Eur J Neurol ; 22(3): 485-92, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25410608

RESUMEN

BACKGROUND AND PURPOSE: Sexual dysfunction (SD) is prevalent in multiple sclerosis (MS) patients and affects quality of life. Furthermore, lower urinary tract dysfunction (LUTD) is common in MS patients. Our aim was to determine the relationship between urodynamic findings and SD in a cohort of MS patients with LUTD. METHODS: From January 2011 to September 2013, 135 consecutive patients with MS in remission phase and LUTD underwent a first urodynamic examination, according to the International Continence Society criteria. Neurological impairment was assessed using the Expanded Disability Status Scale and SD was investigated with the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF-15). Multivariate logistic regression analysis was performed to identify predictors of female SD (FSFI < 26.55) or moderate-severe erectile dysfunction (ED) (IIEF-EF ≤ 16), after adjusting for confounding factors including urodynamic findings. RESULTS: Subjects with maximum detrusor pressure during involuntary detrusor contraction (PdetmaxIDC) ≥20.0 cmH2 O had lower IIEF-EF, IIEF overall satisfaction (IIEF-OS), FSFI-Arousal, FSFI-Lubrication and FSFI-Orgasm. Subjects with maximum cystometric capacity (MCC) ≥135 ml had higher IIEF-EF, intercourse satisfaction (IIEF-IS), orgasmic function (IIEF-OF), sexual desire (IIEF-SD), FSFI-Arousal, FSFI-Lubrication, FSFI-Orgasm, FSFI-Satisfaction and FSFI-Pain. On multivariate logistic regression analysis, PdetmaxIDC ≥20 cmH2 O [odds ratio (OR) 6.7; P < 0.05] and MCC <135 ml (OR 6.80; P < 0.05) were predictors of moderate-severe ED. In a model including all previous variables, compliance ≤3 ml/cmH2 O was an independent predictor of moderate-severe ED (OR 14.49; P < 0.01). No relationship was found between the previous variables and FSFI <26.55. CONCLUSIONS: Neurogenic bladder is associated with SD in MS patients. The presence of PdetmaxIDC ≥20 cmH2 O, MCC <135 ml and compliance ≤3 ml/cmH2 O may significantly predict the presence of moderate-severe ED.


Asunto(s)
Esclerosis Múltiple Recurrente-Remitente/epidemiología , Disfunciones Sexuales Fisiológicas/epidemiología , Vejiga Urinaria Hiperactiva/epidemiología , Urodinámica/fisiología , Adulto , Comorbilidad , Disfunción Eréctil/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
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