The relationship between serum and urinary Fetuin-A levels and kidney stone formation among kidney stone patients.

INTRODUCTION: Mineralization inhibitors are required to prevent the precipitation of minerals and inhibit the formation of kidney stones and other ectopic calcifications. In laboratory studies, Fetuin-A as a glycoprotein has inhibited hydroxyapatite precipitation in calcium and phosphate supersaturated solutions; however, information about patients with kidney stones is limited. The aim of this study was to investigate the association of serum and urinary Fetuin-A levels with calcium oxalate kidney stones. MATERIAL AND METHODS: In this case-control study, 30 patients with kidney stones and 30 healthy individuals without any history of urolithiasis who were referred to the urology ward of Sina Hospital of Tehran, Iran, in 2015 were entered into the study. All patients underwent computerized tomography scans. After collecting demographic information, serum and urine levels of Fetuin-A and some other calcification inhibitors and promoters, were measured and compared using T-test, Mann-Whitney and logistic regression between the two study groups. RESULTS: Patients with kidney stones, on average, had lower levels of Serum Fetuin-A (1522.27 ±755.39 vs. 1914.64 ±733.76 µg/ml; P = 0.046) as well as lower levels of Urine Fetuin-A (944.62 ±188.5 vs. 1409.68 ±295.26 µg/ml; P <0.001). Multivariate logistic analysis showed that urinary calcium and serum creatinine are the risk factors and Fetuin-A is a urinary protective factor for kidney stones. CONCLUSIONS: PFC Our study showed that patients with kidney stones had lower serum and urinary levels of Fetuin-A. In the logistic regression model, urinary Fetuin-A was reported as a protective factor for kidney stones.

EPCA2.22: A Silver Lining for Early Diagnosis of Prostate Cancer.

PURPOSE: To investigate whether EPCA-2 (a prostate matrix nuclear protein) can be a more helpful marker in prostate cancer diagnosis. MATERIALS AND METHODS: 176 patients enrolled in this study had abnormal prostate specific antigen (PSA) or digital rectal examination and were candidates for prostate needle biopsy. Blood samples were obtained from each patient prior to biopsy and the samples were frozen for EPCA-2 measurement. Patients diagnosed with cancer were assigned to the case group and those with benign prostate hyperplasia (BPH) were included in the control group. Univariate and multivariable analyses were done to assess the relationship between different independent variables with cancer diagnosis. The diagnostic power of EPCA-2 for cancer was estimated at different levels of PSA according to the ROC curve. RESULTS: The mean(± SD) age of cancer cases was 70.33(± 9.02) years while it was 63.34(± 9.47) years for BPH cases (P < .01). EPCA-2 and PSA were also significantly different between cancer and BPH cases (P < .001). The multivariable logistic regression showed that EPCA-2 has a significant relationship with cancer diagnosis (OR=1.009, P = .021). After controlling other variables following stratification for PSA, it was shown that EPCA-2 and cancer were correlated just when PSA was >10 (P < .001). AUC was 0.694 for cancer prediction by EPCA-2 when PSA was >10 ng/mL. CONCLUSION: EPCA-2 has the power of differentiating BPH from cancer in prostate cancer suspects. This suggests that EPCA-2 can be helpful in diagnosing prostate cancer and can be a preventive test to avoid unnecessary biopsies considering PSA and age of the patient. .

Is Serum Uric Acid Level Correlated with Erectile Dysfunction in Coronary Artery Disease Patients?

Coronary artery disease (CAD) and vascular insufficiency are consequences of modern lifestyle, and vasogenic erectile dysfunction (ED) is one of the leading causes of sexual dysfunction which could be prevented like ischemic heart disease if the risk factors are discovered and managed. Seventy-five men scheduled for coronary angiography were asked to fill out the IIEF5 questionnaire and underwent serum lipoprotein-a, uric acid, lipid profile, testosterone, Sex Hormone Binding Globulin (SHBG), dehyderoepiandrostendion sulfate (DHEAS) tests; and the results were compared with those of erectile dysfunction patients with and without coronary artery disease. Ten out of 32 CAD patients (30%) and 6 of 43 normal coronary men had ED Prevalence (P=0.04). The average serum uric acid in ED patients with normal coronary was 5.6 (± 0.68) 6.5 ±078 mg/dl in ED patients of CAD group P=0.034. Men with both ED and CAD had significantly higher levels of lipoprotein-a compared to those CAD patients with normal sexual function. Higher uric acid and lipoprotein-a levels are correlated with the presence of ED in patients with CAD.

Association of Serum Fetuin-A Levels with Allograft Outcome in Renal Transplant Recipients.

PURPOSE: To determine serum fetuin-A pattern after renal transplantation and its association with graft outcome. MATERIALS AND METHODS: In 41 renal transplant recipients, serum pretransplant fetuin-A levels and serum fetuin-A concentrations on days 7 and 30 after transplantation were measured using the enzyme-linked immunosorbent as­say (ELISA) method. Also, the association between serum fetuin-A levels with clinical and laboratory parameters was evaluated. RESULTS: A significant decrease in serum fetuin-A levels was noted in the first week after transplantation (P < .001). Subsequently, it started to increase and surpass pretransplant values during the first month (P < .001). Pretransplant fetuin-A levels did not differ among patients with different diethylenetriamine pentaacetic acid (DTPA) results. In addition, serum fetuin-A levels did not significantly correlate with metabolic parameters. CONCLUSION: In this prospective study there was no increase in serum fetuin-A levels during the first month and pretransplant fetuin-A levels are not predictive for allograft outcome in renal transplant recipients.

Does hypertension remain after kidney transplantation?

Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN) in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61%) patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8%) the cause of end-stage renal disease (ESRD) was unknown followed by HTN (26.3%). A total of 166 (41.5%) patients had been hypertensive before transplantation and 234 (58.5%) had normal blood pressure. Among these 234 individuals, 94 (40.2%) developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8%) remained hypertensive after transplantation. Totally 180 (45%) patients had post-transplantation HTN and 220 patients (55%) didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

Role of steroid hormone receptors in formation and progression of bladder carcinoma: a case-control study.

PURPOSE: To compare the expression rate of sex steroid hormone receptors of estrogen (ER), progesterone (PR) and androgen (AR) in normal urothelium and urothelial bladder cancer (UBC) and to evaluate the possible associations of these receptors expression with cancer progression and patient's survival. MATERIALS AND METHODS: We evaluated the clinical data and tumor specimens of 120 patients with pathologically confirmed primary UBC with 132 normal healthy controls. Both patients and controls selected from list of subjects who have been referred to Sina Urology clinic, and had a minimum of one year follow-up duration. Data collected from medical cords. For evaluation of expression, immunohistochemistry was performed on paraffin-embedded tissue sections using a monoclonal antibody for androgen, estrogen and progesterone receptors. Presence of at least 10% positive cells defined as positive expression. RESULTS: None of the control subjects showed AR expression, while 22% of the patients were AR-positive. ER/PR expressions were observed in 4.2%/ and 2.5% of the cases and in 2.3% and 1.5% of the controls, respectively. A statistically significant correlation was found between AR expression and tumor stage and grade (P < .001). AR-positive patients showed a significantly poorer prognosis than AR-negative cases (log-rank test, P = .02, hazard ratio = 2.12; 95% confidence interval: 1.36-4.65). CONCLUSION: AR expression was significantly associated with higher grade and poorly differentiated tumors with unfavorable outcome. AR expression test might be useful as a diagnostic tool for determining the malignancy and outcome of UBC patients. 

Serum uric acid as a risk predictor for erectile dysfunction.

INTRODUCTION: Serum uric acid (UA) is now beginning to be considered a risk predictor for cardiovascular diseases. However, little is known about the effect of hyperuricemia on the risk of developing other systemic vascular disorders, especially erectile dysfunction (ED). AIM: To evaluate whether serum UA is a predicting factor for ED while adjusting for other common risk factors. METHODS: Two hundred fifty-one patients aged 45.2 ± 10.1 years with newly diagnosed and documented ED and 252 age-matched participants without ED (aged 45.1 ± 8.4 years) were enrolled in this case-control study. Univariate and multivariate logistic regression analysis were performed to assess the effect of serum UA on ED; odds ratio (OR) and 95% confidence interval (CI) were calculated. Adjustments were made for potential confounding factors, including obesity, hypertension, diabetes, dyslipidemia, serum triglyceride, and smoking. MAIN OUTCOME MEASUREMENT: Serum UA concentration and the distribution of potential ED risk factors (age, smoking, lipid profile, hypertension, obesity, and diabetes mellitus) were evaluated. Serum UA levels were organized into tertiles. The five-item International Index of Erectile Function was used to evaluate the presence and the severity of ED. RESULTS: The mean serum UA levels in ED-positive and ED-negative groups were 6.12 ± 1.55 mg/dL and 4.97 ± 1.09 mg/dL, respectively (P < 0.001). On analysis of unadjusted variables, statistically significant differences were found for all variables, including serum UA, between ED-positive and ED-negative groups. After adjustment for major risk factors, a significant trend of increasing risk was found for serum UA concentration (OR 5.95, 95% CI 2.96-11.97; P < 0.001, comparing the highest with the lowest tertile). An increase of 1 mg/dL in serum UA level was associated with an approximately twofold increase in risk of ED (OR 2.07; 95% CI 1.63-2.64). CONCLUSIONS: Our findings reveal that serum UA can be considered a risk predictor for ED. Furthermore, hyperuricemia can be regarded as an independent risk factor in addition to the established ones.

Serum calcium concentration and prostate cancer risk: a multicenter study.

This study sought to further evaluate the possible effects of serum calcium level on prostate cancer (PC) risk, with considering the age, body mass index (BMI), and sex steroid hormones. Using data from a prospective multicenter study, serum calcium concentration, as well as thorough demographic and medical characteristics, were determined in 194 cases with newly diagnosed, clinicopathologically confirmed PC and 317 controls, without any malignant disease, admitted to the same network of hospitals. Serum total and ionized calcium levels were categorized into tertiles. Multivariate logistic regression model was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) after adjustment for major potential confounders, including age, BMI, smoking, alcohol, education, occupation, marital status, family history of PC, and sex hormones level. The mean serum calcium level (±SD) in case and control groups was 9.22 (±0.46) mg/dl and 9.48 (±0.51) mg/dl, respectively (P < 0.001). After adjustment for mentioned confounders, a significant trend of decreasing risk was found for serum total calcium concentration (OR = 0.27, 95% CI = 0.12-0.59, comparing the highest with the lowest tertile) and ionized calcium (OR = 0.25, 95% CI = 0.10-0.58). An increase of 1 mg/dl in serum calcium level was associated with a significant decrease in PC risk (OR = 0.52; 95% CI = 0.34-0.76). Our findings reveal the inverse association between serum total and ionized concentrations and PC risk, which supports the hypothesis that calcium may protect against PC. Furthermore, no evidence was found regarding age, BMI, and sex steroid hormones to modify the association between serum calcium and PC risk.

Five-year clinical effects of donor bone marrow cells infusions in kidney allograft recipients: improved graft function and higher graft survival.

Augmentation of microchimerism in solid organ transplant recipients by donor bone marrow cells (DBMC) infusion may promote immune hyporesponsiveness and consequently improve long-term allograft survival. Between March 2005 and July 2007, outcomes for 20 living unrelated donor (LURD) primary kidney recipients with concurrent DBMC infusion (an average of 2.19 ± 1.13 x 109 donor cells consisting of 2.66 ± 1.70 x 107 CD34⁺ cells) were prospectively compared with 20 non-infused control allograft recipients given similar conventional immunosuppressive regimens. With five years of clinical follow up, a total of 11 cases experienced rejection episodes (3 DBMI patients vs. 8 controls, p = 0.15). One DBMC-infused patient experienced chronic rejection vs. two episodes (1 biopsy-confirmed) in the control patients. Actuarial and death-censored 5-y graft survival was significantly higher in infused patients compared with controls (p = 0.01 and p = 0.03, respectively). Long-term graft survival was significantly associated with pre-transplant anti-HLA antibodies (p = 0.01), slightly with peripheral microchimerism (p = 0.09) and CD4⁺CD25⁺FoxP3⁺ T cells (p = 0.09). Immunosuppressant dosing was lower in infused patients than controls, particularly for mycophenolate mofetil (p = 0.001). The current findings as well as our previous reports on these patients indicates clinical improvement in long-term graft survival of renal transplant patients resulting from low-dose DBMC infusion given without induction therapy.

The association between dietary antioxidant intake and semen quality in infertile men.

BACKGROUND: Oxidative stress is detrimental to semen quality and has a significant role in the etiology of malesubfertility. METHODS: Dietary intake of antioxidants were compared between thirty two men with oligolastheno/ teratazoospermic(cases) and 32 normospermic volunteers (controls) attending fertility clinic in Mirza Koochak-khanHospital in Tehran, Iran. All participants were nonsmokers and matched according their age and Body MassIndex (BMI). Nutrient consumption was calculated using a semi- quantitative food frequency questionnaire.Semen samples were collected and were assessed by measuring volume, concentration, motility and morphology. RESULTS: infertile subjects had a significantly lower intake of zinc and folate compare to control ones(p<0.001). Dietary intake of vitamin C and E was lower than recommended values in 59.4% of case group thatwas significantly different from control ones (p<0.05). In control group, 36.4 and 40.9% of participants had insufficientdietary intake of vitamin C and E, respectively. Significant correlations were found between folate(r=0.5, p<0.001), zinc (r=0.6, p<0.001) and percentage of motility and also between vitamin E and morphology(r=0.3, p=0.03), zinc and concentration (r=0.4, p=0.004) in all participants. CONCLUSION: summary, a low intake of folate, zinc, and vitamin E were related to poor sperm concentrationand motility.

Donor-derived peripheral mononuclear cell DNA is associated with stable kidney allograft function: a randomized controlled trial.

A large body of literature has documented an inconsistent relationship of peripheral donor cell chimerism with alloimmune tolerance following kidney transplantation. We revisit this association with assays capable of quantifying cellular microchimerism with 150-1500-fold greater sensitivity than previously utilized allo-antibody based flow cytometric approaches. Forty renal transplant patients, 20 with concurrent donor bone marrow infusion (DBMI) and 20 control participants without infusion were prospectively monitored for peripheral blood microchimerism using donor polymorphism-specific quantitative real-time PCR. Thirty-eight patients were evaluated for microchimerism, 19 in each group. The frequency of testing positive for (95% vs. 58%, p = 0.02) and mean concentrations of microchimerism (115 ± 66 vs. 13 ± 3 donor genomes/million recipient genomes, p = 0.007), respectively, were higher in infused patients compared with controls. Thirty-one patients maintained stable graft function; 17 in the DBMI group vs. 14 in controls. Patients with stable graft function in the DBMI group compared with control patients harbored microchimerism more frequently (94 vs. 50%, p = 0.01) and at higher concentrations (123 ± 67 vs. 11 ± 4, p = 0.007), respectively. Significant correlation between dose of infused cells and microchimerism levels was found post-transplant (p = 0.01). Using very sensitive assays, our findings demonstrate associations between the presence and quantity of microchimerism with stable graft function in infused patients.

Major dietary factors and prostate cancer risk: a prospective multicenter case-control study.

The association between diet and prostate cancer (PC) risk, although suggestive, still remains largely elusive particularly in the Asian population. This study sought to further evaluate the possible effects of different dietary factors on risk of PC in Iran. Using data from a prospective hospital-based multicenter case-control study, dietary intakes of red meat, fat, garlic, and tomato/tomato products, as well as thorough demographic and medical characteristics, were determined in 194 cases with the newly diagnosed, clinicopathologically confirmed PC and 317 controls, without any malignant disease, admitted to the same network of hospitals. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were obtained after adjustment for major potential confounders, including age, body mass index, smoking, alcohol, education, occupation, family history of PC, and total dietary calories. Comparing the highest with the lowest tertile, a significant trend of increasing risk with more frequent consumption was found for dietary fat (OR: 1.79, 95% CI: 1.71-4.51), whereas inverse association was observed for tomato/tomato products (OR: 0.33, 95% CI: 0.16-0.65). A nonsignificant increase in PC risk was revealed for dietary red meat (OR: 1.69, 95% CI: 0.93-3.06). For garlic consumption, a borderline reduction in risk was observed (OR: 0.58, 95% CI: 0.32-1.01; P = 0.05). In conclusion, our study supports the hypothesis that total fat may increase PC risk and tomatoes/tomato products and garlic may protect patients against PC.

Circulating sex hormones play no role in the association between sexual activity and the risk of prostate cancer.

INTRODUCTION: High sexual activity (SA) has been reported to reduce the risk of prostate cancer (PC). The role of sex hormones (SHs) in this regard remains controversial. AIMS: To determine the impact of SA and SHs on PC development. METHODS: In a multicentric hospital-based case-control study, 194 newly diagnosed PC patients along with 317 age-matched controls were studied. Sociodemographic and medical characteristics of participants were recorded. History of vasectomy and sexually transmitted infection (STI), marital status, age at first intercourse, premarital sex, and the current frequency of sexual intercourses per month (SPM) were evaluated. Total testosterone (TT), free testosterone (FT), estradiol (ES), sex hormone binding globulin, and albumin were also measured. Logistic regression model was used to identify independent risk factors for PC. MAIN OUTCOME MEASURES: (i) The association between SA, SHs, and the risk of PC; (ii) The correlation between SHs and SA; (iii) The interaction between SHs and SA and established risk factors for PC and erectile dysfunction in determining the risk of PC; and (iv) The correlation between SHs and SA in determining the risk of PC in different decades of life. RESULTS: Vasectomy, STI, and marital status did not differ significantly between two cohorts. Controls reported premarital sex more commonly than cases (P < 0.001). Cases had the first intercourse at older age (P = 0.03) and had less SPM (P < 0.001). TT, FT, and ES were higher in controls (P < 0.001). In multivariate analysis, TT, calculated FT, SPM >4, and age at time of marriage <24 were protective against PC. The protective effect of high SA and SHs increased as patients' age increased. CONCLUSIONS: High SA as well as TT and FT were protective against PC. Their protective role enhances by each decade of increasing age. The protective effect of high SA was independent from circulating levels of SHs.

Effect of penile-extender device in increasing penile size in men with shortened penis: preliminary results.

INTRODUCTION: It has been suggested that the application of penile-extender devices increases penile length and circumference. However, there are a few scientific studies in this field. AIMS: The aim of this study was to assess the efficacy of a penile-extender (Golden Erect(®) , Ronas Tajhiz Teb, Tehran, Iran) in increasing penile size. METHODS: This prospective study was performed on subjects complaining about "short penis" who were presented to our clinic between September 15, 2008 and December 15, 2008. After measuring the penile length in flaccid and stretched forms and penile circumference, patients were instructed to wear Golden Erect(®) , 4-6 hours per day during the first 2 weeks and then 9 hours per day until the end of the third month. The subjects were also trained how to increase the force of the device during determined intervals. The patients were visited at the end of the first and third months, and penile length and circumference were measured and compared with baseline. MAIN OUTCOME MEASURES: The primary end point of the study was changes in flaccid and stretched penile lengths compared with the baseline size during the 3 months follow-up. RESULTS: Twenty-three cases with a mean age of 26.5 ± 8.1 years entered the study. The mean flaccid penile length increased from 8.8 ± 1.2 cm to 10.1 ± 1.2 cm and 10.5 ± 1.2 cm, respectively, in the first and third months of follow-up, which was statistically significant (P < 0.05). Mean stretched penile length also significantly increased from 11.5 ± 1.0 cm to, respectively, 12.4 ± 1.3 cm and 13.2 ± 1.4 cm during the first and second follow-up (P < 0.05). No significant difference was found regarding proximal penile girth. However, it was not the same regarding the circumference of the glans penis (9.3 ± 0.86 cm vs. 8.8 ± 0.66 cm, P < 0.05). CONCLUSION: Our findings supported the efficacy of the device in increasing penile length. Our result also suggested the possibility of glans penis girth enhancement using penile extender. Performing more studies is recommended.

Transdermal delivery of bioidentical progesterone using dutasteride (A 5α-reductase inhibitor): a pilot study.

PURPOSE: Bioavailability of transdermal progesterone is low and variable. This may be attributed to transdermal metabolism by the 5α-reductase enzymes or the direct transport to the saliva. The objective of the current study was to evaluate the effect of enzyme inhibition on the bioavailability of transdermal progesterone. Serum and salivary progesterone levels were evaluated to gain a better insight into the mechanism progesterone transport across the skin. METHOD: Twenty postmenopausal women with a Follicle Stimulating Hormone > 40IU/L were recruited to take part in the study. The subjects were randomly allocated to either dutasteride (n=10) or placebo (n=10). Each group applied either 500 mg of non ionic cream or dutasteride cream (2mg/g) to the right arm for 2 weeks. This was followed by applying 500 mg of progesterone or progesterone dutasteride cream (equivalent to 40 mg of progesterone) for a further 2 weeks. On day 30 blood and saliva were collected for over 12 hours and progesterone concentration was measured. RESULTS: The baseline progesterone concentration on day zero was 0.1 ng/ml. On day 30 baseline progesterone levels increased significantly (p <0.05) to 1.40 ng/ml and 1.15 ng/ml in the progesterone and dutasteride groups, respectively. Salivary progesterone concentrations were increased by seven fold, from 0.40 ng/ml to 2.9 ng/ml. On average, salivary progesterone concentration was four times the serum levels. CONCLUSION: The average serum and salivary progesterone concentration, Cmax, and the AUC were slightly higher in the dutasteride group, but no significant difference could be noted. Metabolism by the 5α-reductase enzyme is unlikely to affect the bioavailability of progesterone.

Complications and outcomes following extracorporeal shock wave lithotripsy: a prospective study of 3,241 patients.

Extracorporeal shock wave lithotripsy (SWL) has become the least invasive treatment modality with high success rates for urinary calculi; however, its established efficacy has been associated with a number of side effects and complications. This study sought to further evaluate the incidence rate and management of the post-SWL complications and also the efficiency of procedure in a large scale of patients. During a 51-month period, 3,241 consecutive adult patients with the mean age of 38.1 years (range 15-75) and urinary calculi (>or=4 mm) underwent SWL at our referral center and were followed for 3 months prospectively. Overall, 3,614 stones [kidneys (83.5%), ureters (15.8%) and bladder (0.7%)] in 3,241 patients were treated requiring 7,245 SWL sessions. Stone-free state occurred in 71.5% calculi and success rate in 79.8% patients. The re-treatment was necessary in 37.2% patients. Auxiliary procedure and efficiency quotient were 5.6% and 0.50, respectively. SWL success rate decreased as the stone size increased (P < 0.0001). The stone-free rate was correlated with the location of the stone. During the study period, 4,075 complications occurred in our patients. Colicky pain (40%) was the most frequent symptom followed by gross hematuria (32%) and steinstrasse (24.2%). Symptomatic bacteriuria developed in 9.7% patients; Escherichia coli (30.4%) was the most causative organism. In conclusion, the complication rate following SWL was high in our study; however, the majority was mild and managed conservatively or with the minimal intervention. Moreover, the management of urinary calculi in adults using SWL was proved to be safe and efficient, particularly for ureteral stones <10 mm, renal pelvic stones <20 mm, and bladder stones <30 mm.

Erectile dysfunction severity as a risk predictor for coronary artery disease.

INTRODUCTION: Erectile dysfunction (ED) is now beginning to be considered as an early manifestation of a subclinical systemic vascular disorder and may be an index of subclinical coronary artery disease (CAD). AIM: To further evaluate whether ED is a predicting factor for CAD while adjusting for other common risk factors. METHODS: One hundred eighty-three patients with newly diagnosed and documented CAD and 134 participants without CAD were enrolled in this case-control study at our referral center. Univariate and multivariate logistic regression analysis were performed to assess the effect of classic risk factors and ED severity on CAD; calculating odds ratio (OR) and 95% confidence interval (CI). Adjustments were made for potential confounding factors including age, hypertension, diabetes, dyslipidemia, obesity, and smoking. MAIN OUTCOME MEASURES: The prevalence of ED and the distribution of CAD risk factors (age, smoking, lipid profile, hypertension, obesity, and diabetes mellitus) were evaluated. The 5-item International Index of Erectile Function was used to evaluate the presence and the severity of ED. RESULTS: The prevalence of ED in CAD-positive and CAD-negative groups was 88.5% and 64.2%, respectively (P < 0.05). A statistically significant difference was found for all risk factors (except total cholesterol and low-density lipoprotein levels), and also ED prevalence between studied groups. Adjusted OR for age, diabetes, hypertension, hypercholesterolemia, and smoking demonstrated a significant confounding effect. Our results also revealed a significant association between severe ED and CAD (OR: 2.22, 95% CI: 1.11-6.03; P < 0.05). CONCLUSION: This study suggests that ED could be considered as a surrogate marker which can predict the occurrence of CAD, and severe ED could be regarded as an independent risk predictor in addition to the established ones.

Anabolic-androgenic steroid effects on early morbid symptoms after open prostatectomy: a pilot study.

OBJECTIVES: Anabolic-androgenic steroids such as Nandrolone phenpropionate (NP) dramatically improve the tolerance to acute stress conditions, strength, and subsequently the quality of life in elderly men. We hypothesize that preoperative pulse-dose supraphysiological NP administration might improve the early morbid symptoms in older patients undergoing open prostatectomy. METHODS: From 2005 to 2006, 54 patients with a mean age of 70 years, diagnosed as benign prostatic hyperplasia and hospitalized for open prostatectomy were enrolled in the study. They were randomly selected to receive preoperative supraphysiological NP (100 mg, intramuscularly, pulse-dose) or sesame oil placebo, prospectively. Early postoperative morbid symptoms including subjective urinary symptoms (dysuria, bladder retention sensation), incision site pain and general satisfaction of their current urinary condition were assessed by a 6-point scale, self-administrated questionnaire at 24 and 48 h, postoperatively. The sex hormone binding globulin and the testosterone levels were also measured. RESULTS: The 24-h postoperative symptoms were significantly reduced in the NP group compared to the placebo (6.18 +/- 2.81 versus 9.77 +/- 2.15; P < 0.001). The postoperative symptoms were reported to have a decline in the 48 h following operation, though was calculated to be statistically insignificant (4.48 +/- 2.32 versus 5.55 +/- 1.84; P = 0.06). There was no complication attributed to NP therapy. CONCLUSIONS: The data supported the hypothesis that the preoperative anabolic steroid supplements (such as NP) could result in a better postoperative endurance in elderly men undergoing open prostatectomy. Further studies, longer and repeated pulse injections in a larger number of older men are mandatory to prove the claim.

Serum selenium level and prostate cancer: a case-control study.

Selenium is a potential chemopreventive agent against prostate cancer. This study sought to evaluate and compare the serum selenium level in men with newly diagnosed prostate cancer and noncancerous patients. Between 2005 and 2006, this prospective case-control study was performed on patients referred to Sina and Imam University hospitals, Tehran, Iran; it included 62 men with clinicopathologically confirmed diagnosis of prostate cancer (case group) and 68 men with no detectable prostate cancer [normal digital rectal examination and prostate-specific antigen (PSA) level] or any other malignant disease (control group). The serum selenium level was assessed using Zeeman graphite furnace atomic absorption spectrometer (Varian Company, Australia). The mean serum selenium level in the case and control group was 66.3 +/- 17.7 microg/l and 77.5 +/- 22.5 microg/l, respectively (P = 0.002). Serum selenium was inversely associated with prostate cancer risk. After adjustment for age, body mass index (BMI), and smoking, the odds ratio was 0.16 and 95% confidence intervals were 0.06 to 0.47 (P trendq = 0.001) comparing the highest with the lowest tertile (> or = 89.3 microg/l). No correlation was observed between serum selenium level and age, BMI, or PSA level. In conclusion, serum selenium levels in prostate cancer cases were lower than in controls, which supports the hypothesis that selenium may protect against prostate cancer.