Low testosterone and sexual symptoms in men with acute coronary syndrome can be used to predict major adverse cardiovascular events during long-term follow-up.

Low total testosterone (TT) and sexual symptoms are common among men with coronary artery disease, however its impact on major adverse cardiovascular events (MACE) is still debatable. We investigated whether low TT and coexisting sexual symptoms in men with acute coronary syndrome (ACS) can be used to predict the incidence of MACE. In the prospective study 120 consecutive men (mean age 58 ± 9 years; diabetes 27%; current smokers 58%; left ventricular ejection fraction 50 ± 10%) with ACS were included. The group of men with the presence of three sexual symptoms (decreased frequency of morning erections, a lack of sexual thoughts and erectile dysfunction) and with TT serum concentration <3.2 ng/mL was distinguished. All of the patients had their prognosis assessed according to the Global Registry of Acute Coronary Events (GRACE Score 2.0). Primary composite endpoint - MACE (recurrent ischaemia, non-fatal myocardial infarction, stroke and death) and secondary endpoint - in stent restenosis (ISR) were registered during the 18.3 month follow-up period. The mean TT level in the entire group was 3.7 ± 0.5 ng/mL. Low TT was diagnosed in 63 (52.5%) men. Both low TT and sexual symptoms were diagnosed in 57 (47%) participants. During the follow-up, 29 (24.2%) participants experienced MACE, 20 (16.6%) men ISR. In the Cox proportional hazards regression, high risk of death on the GRACE score (HR 3.16; 95% CI: 1.5-6.6; p = 0.002), the presence of low TT and sexual symptoms (HR 2.75; 95% CI: 1.26-6.04; p = 0.02) independently predicted an incidence of a MACE (p = 0.006). For the secondary endpoint only low TT and sexual symptoms (HR 2.68; 95% CI: 1.03-6.94; p = 0.034) were independent covariates which predicted IRS. Low TT which coexists with sexual symptoms in males with ACS can be used to predict MACE, especially IRS independently of classic cardiovascular risk factors.

Safe biotechnology. 7. Classification of microorganisms on the basis of hazard. Working Party "Safety in Biotechnology" of the European Federation Biotechnology.

The current systems for classifying human pathogens on the basis of hazard are well developed and their basic criteria are in general agreement one with another. Of more importance, the safety practices based on these classifications have generally been successful. They have enabled extensive research activities, medical practice and industrial production to be conducted on an ever-increasing scale, involving dangerous microorganisms (e.g. in vaccine production and treatment of infected patients) with a very low incidence of adverse effects on the workers involved and the general public. Although the EU has adopted a harmonised list of agents in groups 1-4 there is as yet no complete agreement among member states and individual microbiologists. The purpose of this paper is to present a historical survey and to discuss the current processes for identifying and classifying the hazards posed by the use of microorganisms in research and technology. This is essential in the design of appropriate methods of counteracting potential risks.

Safe biotechnology. Part 6. Safety assessment, in respect of human health, of microorganisms used in biotechnology.

The assessment of microorganisms in respect to human health is an important step for the introduction of new natural and genetically modified production strains to biotechnology. This report outlines the potential hazards posed by industrial microorganisms, important considerations related to pathogenicity, such as routes and portals of entry into the human body, mechanisms of spread of biological material and a definition of pathogenicity. Furthermore the most important steps in the assessment of pathogenicity of unknown strains are described. A short overview on characterization and in vitro and in vivo tests is presented. The hazard related to allergens and toxic metabolites is reviewed and the choice of methods and the handling of strains with unknown potential are discussed.

[New trends in studies of the pharmacologic activity of microbial metabolites]. / Nowe kierunki w badaniach aktywnosci farmakologicznej metabolitów drobnoustrojowych.

A new broad concept and novel approaches in the search for bioactive microbial metabolites are discussed. Methodology of the screening systems and assay techniques for the pharmacological and immunopharmacological activity of these products is presented. The value of the preliminary target-selective screening procedures is illustrated with a number of the pharmacologically active microbial products, among which the enzyme inhibitors are extremely important. Products with immunopharmacological activity are developed for organ transplantation and antitumor therapy. Another question discussed in the paper is non-antimicrobial and non-antitumor applications of the antibiotics.

Biosynthesis of cephamycin by resting cells of Streptomyces lactamdurans L 2/6.

In order to investigate the nutritional conditions of cephamycin biosynthesis independently of the biomass growth process, the nutrient limited-resting cell system was used. A replacement medium eliminating cell multiplication was developed. The presence of Mg2+, carbon source and nitrogen source was necessary for cephamycin production by resting cells of Streptomyces lactamdurans L 2/6. Maximum antibiotic production was obtained when maltose, saccharose, and fructose were used as carbon source, and L-asparagine as nitrogen source. An inhibitory effect on the process was exerted by the calcium ions. There was no visible inhibition of cephamycin biosynthesis by inorganic phosphate ions in concentration up to 100 mM.

Cell proliferation-cephamycin biosynthesis relationship in the culture of Streptomyces lactamdurans L 2/6: phosphate regulation.

During batch cultivation of Streptomyces lactamdurans a diauxic growth has been shown taking into consideration dry cell mass, protein, and DNA determination. This phenomenon was connected with substantial changes in environmental conditions such as concentrations of ammonia and amino nitrogen, soluble inorganic phosphate and pH. The antibiotic production was preceded by the preparatory phase occurring at the beginning of the second growth phase. A hypothetical pattern of cell physiology in the curse of cephamycin fermentation is discussed. An essential part in the biphasic cell growth and the induction of antibiotic synthesis in this model is played by phosphate depletion in the medium.

The long-distance psychiatric patient in the emergency room. Insights regarding travel and mental illness.

This paper deals with the motivational, demographic and clinical characteristics of individuals who seek psychiatric help at facilities located a great distance from their places of residence. The study identifies two subgroups within this category. The first (Intentional or Type A) group is constituted by persons who, owing to their concerns with the social stigma of mental illness, or driven by the desire for a magical solution to their problems, purposely undertake the journey to a distantly located psychiatric center. The second (Incidental or Type B) group consists of vacationers, hitch-hikers and skid-row individuals. While these "long distance patients" (LDP) did not show any differences when compared with the remainder of clinic attendance on demographic variables, distinct clinical features differentiated the two populations. Most significantly the LDP had a higher incidence of schizophrenia and alcohol related problems. The difference was entirely accounted for by the Type B subgroup ((LDP less than 0.01; Type A, NS; Type B less than 0.001). Implications of this finding have been discussed in view of the suggested relationships between travel and mental illness. Administrative problems of the LDP have been briefly commented upon.

Kinetic studies on citric acid production by Aspergillus niger. I. Phases of mycelium growth and product formation.

The physiology and growth kinetics of Aspergillus niger B-64-5 in shaken culture were studied, five successive phases of citric acid fermentation being distinguished. Growth was found to be diauxic, spore germination being followed by an exponential growth phase, then a period of growth disturbance, and last of all a phase of secondary growth, characterized by a constant coefficient of growth decline appeared. The citric acid production started in the phase of growth disturbance. The chief increase in citric acid concentration took place in the production phase, i.e. in the last fermentation phase.

Kinetic studies on citric acid production by Aspergillus niger. II. The two-stage process.

A two-stage process of submerged citric acid fermentation with replacement of growth medium by fermentation medium has been worked out. The optimum composition of mineral nutrients and pH of the fermentation medium of the second stage of the process were determined. An addition of 0.5 g/l of NH4NO3 as nitrogen source and 0.1 g/l of MgSO4-7H2O as magnesium source ensured effective conversion of sucrose to citric acid. An addition to KH2PO4, on the other hand, was definitely unfavourable as it considerably reduced the product yield. The medium for the second stage of fermentation should be acidified to about pH 2.2, while the water used for washing the mycelium from the remains of the growth medium should have a pH of 2.5--3.5. Under these conditions, with an initial sucrose concentration of 100 g/l, after 132 hr fermentation at 26 degrees up to 90 g/l of citric acid was obtained, which corresponds to a productivity of over 16 g/l. day. The highest activity for citric acid formation was found in three- or four-day-old mycelium.