Sexual bother and function after radical prostatectomy: predictors of sexual bother recovery in men despite persistent post-operative sexual dysfunction.

Changes in sexual bother (SB) following radical prostatectomy (RP) negatively affect health-related quality of life (HRQoL) of prostate cancer survivors. However, post-operative SB tends to be neglected whereas sexual function (SF) is thoroughly assessed in clinical practice and few studies have focused on and evaluated patients' SB. We retrospectively reviewed 2 345 consecutive patients who underwent RP between 2001 and 2009 at a single institution. SF and SB were assessed using Expanded Prostate Cancer Index Composite (EPIC) questionnaires. We stratified our cohort by SB recovery and post-operative SF status, including a subset of men who recovered SB despite persistent post-RP sexual dysfunction. Multivariable logistic regression analyses were conducted to identify factors for men who have SB recovery. Of 319 eligible patients, 133 (41.7%) recovered their SB at a mean of 20 months after RP. Among the 133 men who demonstrated SB recovery, 109 had post-operative sexual dysfunction. Patients with SB recovery despite post-RP sexual dysfunction were more likely to be old (p = 0.004), to have higher clinical T stage (p < 0.001), to have more non-nerve-sparing RP (p < 0.001), to have lower pre-operative EPIC-SF/SB scores (p < 0.001), to have more extracapsular extension (p = 0.031) and to be PDE5i non-users after surgery (p < 0.001). In multivariable analysis, predictors for this subset were lower comorbidity (OR 0.62, p = 0.043), higher clinical cancer stage (OR 2.35, p = 0.026), worse pre-operative SF (OR 0.98, p = 0.010), SB (OR 0.98, p < 0.010) and no PDE5i use (OR 0.37, p = 0.002); age was not related (OR 0.99, p = 0.555). As SB can influence patients' overall HRQoL, expectations of SB recovery should be provided to patients in the same way that SF recovery is presented. This study may help clinicians to discuss SB with patients and assess their potential for SB recovery following RP.

[Absorption of D-xylose in intestinal parasitic diseases]. / Absorción de la D-xilosa en las parasitósis intestinales

In order to investigate the intestinal absorption in relation to parasitic diseases, 106 children were studied using the xylose test. All of them were attending a primary school. The height and weight were recorded, and the hemoblobin and hematocrit were estimated in each one. The examination of the stools shown one or more parasites in 57.6 per cent specimens. The E. histolytica, Hymenolepis nana and A. lumbricoides, were identified in 22.6, 21.7 and 20.7 per cent children, respectively; G lamblia was found in 10.4 per cent. Only the children with Giardia had a statistical difference in the absorption of xylose, with respect to those without parasites. At the same time height was low in comparison to a group of children with similar age and sex, selected among the 45 without parasitic diseases. Findings are discussed according to the pathogenic mechanism involved in giardiasis. Emphasis is done in the interplay of malnutrition and G. lamblia.

[Protein absorption in children with giardiasis]. / Absorción de proteínas en niños con giardiasis.

With the object of investigating if Giardiasis interferes in the intestinal absorption of proteins, a study was made testing the absorption of gelatin in eleven. The determination of alpha-aminonitrogen, before giving gelatin, and the increase shown two hours later, was the criterion used to measure the capacity of absorption. Once the estimated basal had been carried out each of the children received tinidazol for three days, after which the large amount of gelatin was given once again so as to estimate any changes in the absorption, one the parasite had been eliminated. The results demonstrate that the presence of giardia in the intestine significantly restricts the absorption of the gelatin. We offer as proof the results of these findings in the growth of children who harbour this parasite.

Possible role of calmodulin in excystation of Giardia lamblia.

The protozoan Giardia lamblia initiates infection when trophozoites emerge from a cyst in the hosts by the excystation process. Although this process is crucial to the initiation of infection by G. lamblia, little is known about its regulation. To study the possible involvement of calmodulin (CaM) in excystation we tested the effect of several CaM antagonists (TFP, W-7, and W-5) on this cellular function. Except for W-5 the rest of these compounds inhibited excystation. The protein kinase C inhibitor H-7 had no effect on excystation, suggesting that CaM antagonists acted by selectively inhibiting CaM. Furthermore, CaM was redistributed after the induction of excystation and there was an increase in its fluorescence and activity. These results suggest that a CaM-dependent process is involved in G. lamblia excystation.

[Height of children with G. lamblia and there capacity to absorb d-xylose]. / La talla en niños con G. lamblia y su capacidad para absorber d-xilosa

The investigation was carried out with the purpose of studying the capacity to absorb d-xylose in children with G. lamblia establishing also, whether or not their height was reduced. The study is included 25 school age children with giardiasis, pairing them according to sex and age with another 25 without intestinal parasitosis.

Antigens in electron-dense granules from Entamoeba histolytica as possible markers for pathogenicity.

In vitro interaction of Entamoeba histolytica with collagen induces intracellular formation and release of electron-dense granules (EDG) and stimulation of collagenolytic activity. Purified EDG contain 1.66 U of collagenase per mg of protein. Thus, EDG may participate in tissue destruction during invasive amebiasis. Monoclonal antibodies (MAbs) L1.1 and L7.1 reacted specifically with EDG in enzyme-linked immunosorbent assay (ELISA) and immunofluorescence and immunoelectron microscopy. MAb L7.1 immunoprecipitated three polypeptides with molecular weights of 95,000, 68,000, and 28,000 from lysates of biosynthetically labeled E. histolytica. Both MAbs recognized the pathogenic E. histolytica axenic strains HM1:IMSS, HM38:IMSS, and HK-9 but failed to react in ELISA with Entamoeba moshkovskii, Entamoeba invadens, and E. histolytica-like Laredo. In addition, MAb L7.1 reacted with one E. histolytica isolate from a symptomatic patient but did not react with four of five isolates from asymptomatic patients. EDG antigens were detected by a MAb L7.1-based ELISA in E. histolytica-containing fecal samples from symptomatic, but not asymptomatic, individuals. These results suggest that the EDG antigen detected with MAb L7.1 may be differentially expressed in pathogenic and nonpathogenic E. histolytica.