Pertussis prevalence among adult patients with acute cough.

BACKGROUND: Bordetella pertussis infection remains an important health problem in adults due to the increasing prevalence in recent years. Pertussis in adults can be easily overlooked or misdiagnosed. We aimed to determine the prevalence of pertussis in adult patients with acute cough and the clinical features of the pertussis cases. METHODS: Internal Medicine and Pulmonology inpatient wards and outpatient clinics were screened between March 2017 and June 2018. Patients with cough duration between 1 week and 1 month were enrolled. Those who were on antibiotics for more than 5 days were excluded. A total of 115 patients were enrolled. Nasopharyngeal swabs were taken and real-time polymerase chain reaction analyses were done. RESULTS: According to the pertussis case definition, 47.8% of the patients were diagnosed with probable pertussis. We found the prevalence of pertussis as 3.5% in our cohort. All of the patients with pertussis had a history of paroxysmal cough with a mean duration of 20 days. DISCUSSION: These results show that pertussis continues to be a health problem for adults and may present with acute cough. The growing number of adult pertussis cases suggest that vaccination of children is inadequate to prevent pertussis and the concept of 'lifelong vaccination' should be strengthened.

The anabolic applications of androgens in older adults with functional limitations.

Aging is associated with a progressive decrease in skeletal muscle mass, strength and power and impairment of physical function. Serum testosterone concentrations in men decrease with advancing age due to defects at all levels of the hypothalamic-pituitary-testicular axis. Testosterone administration increases skeletal muscle mass, strength and power in older men with low or low normal testosterone levels, but the effects on performance-based measures of physical function have been inconsistent. Adequately powered randomized trials are needed to determine the long-term safety and efficacy of testosterone in improving physical function and quality of life in older adults with functional limitations.

Benefits and Risks of Testosterone Treatment of Older Men with Hypogonadism.

Total and free testosterone levels decline in men with advancing age due to defects at all levels of the hypothalamic-pituitary-testicular axis. Testosterone treatment of older men with low testosterone levels is associated with improvements in sexual activity, sexual desire, and erectile function; lean body mass, muscle strength, and stair climbing power, and self-reported mobility; areal and volumetric bone mineral density, and estimated bone strength; depressive symptoms; and anemia. Long-term risks of cardiovascular events and prostate cancer during testosterone treatment remain unknown. Testosterone treatment may be offered on an individualized basis to older men with unequivocally low testosterone levels and symptoms or conditions associated with testosterone deficiency after consideration of potential benefits and risks, burden of symptoms, and patient's values.

Accurate measurement of total and free testosterone levels for the diagnosis of androgen disorders.

The circulating concentrations of total and free testosterone vary substantially in people over time due to biologic factors as well as due to measurement variation. Accurate measurement of total and free testosterone is essential for making the diagnosis of androgen disorders. Total testosterone should ideally be measured in a fasting state in the morning using a reliable assay, such as liquid chromatography tandem mass spectrometry, in a laboratory that is certified by an accuracy-based benchmark. Free testosterone levels should be measured in men in whom alterations in binding protein concentrations are suspected or in whom total testosterone levels are only slightly above or slightly below the lower limit of the normal male range for testosterone.

Tissue fat quantification by magnetic resonance imaging: proton density fat fraction in polycystic ovary syndrome.

RESEARCH QUESTION: What are the potential differences between lean women with and without polycystic ovary syndrome (PCOS) in fat content in liver, vertebrae, paraspinal muscles, pancreas, subcutaneous (SCAT) and visceral adipose tissue (VAT)? Magnetic resonance imaging proton density fat fraction (PDFF) was used to establish these differences. This is a novel, non-invasive, operator-independent method with comparable diagnostic sensitivity and specificity to histologic examination for fatty liver disease, and strong correlation with muscle strength in neuromuscular studies. DESIGN: Twenty lean women with PCOS (mean age 23.9 ± 2.3; body mass index [BMI] 22.4 ± 2.0) and 20 age- and BMI-matched healthy women (mean age 24.9 ± 1.5; BMI 21.5 ± 1.9) were enrolled in this cross-sectional study. Anthropometric, biochemical and hormonal evaluations along with magnetic resonance imaging proton density fat fraction were carried out. RESULTS: PDFF% measurements of liver, SCAT and VAT were higher in the PCOS group, indicating increased fat content in these areas in lean women with PCOS compared with controls (P = 0.045, 0.030 and 0.037, respectively). In contrast, PDFF% values of vertebrae and paraspinal muscles in the PCOS group were lower than controls (P = 0.038 and 0.05, respectively). Pancreatic PDFF% measurements were similar between the groups. In the PCOS group, PDFF% of VAT was positively correlated with free androgen index (r = 0.69, P = 0.002). CONCLUSIONS: PDFF% measurement, an MRI-based novel biomarker, reveals increased fat in liver, SCAT and VAT, and decreased fat in vertebral bones and paraspinal muscles of lean women with PCOS.