Sex and the cystectomized male: A lack of communication,a need for education

When cancer of the bladder is treated by removal of the malignant organ, there is a high incidence of impotency in males. A retrospective study of 71 adult patients revealed misconceptions, misinformation, and misinterpretation that could have been alleviated by more timely and appropriate counsel. Nurse-enterostomal therapists are identified as potentially valuable sex counselors but their training in this field is limited. A need for patient education is demonstrated and a plea for follow-up attention to sexual concerns in the extended postoperative period is issued.     

Effects of gustatory stimulants of salivary secretion on salivary pH and flow: a randomized controlled trial

Objectives:  To compare salivary pH changes and stimulation efficacy of two different gustatory stimulants of salivary secretion (GSSS).
Setting:  Portuguese Dental Faculty Clinic.
Design:  Double blind randomized controlled trial.
Subjects:  One hundred and twenty volunteers were randomized to two intervention groups. Sample sized was calculated using an alpha error of 0.05 and a beta of 0.20.
Materials and methods:  Participants were randomly assigned to receive a new gustatory stimulant of secretory secretion containing a weaker malic acid, fluoride and xylitol or a traditionally citric acid-based one. Saliva collection was obtained by established methods at different times. The salivary pH of the samples was determined with a pH meter and a microelectrode.
Main outcome measures:  Salivary pH variations and counts of subjects with pH below 5.5 for over 1 min and stimulated salivary flow were the main outcome measures.
Results:  Both GSSS significantly stimulated salivary output without significant differences between the two groups. The new gustatory stimulant of salivary secretion presented a risk reduction of 80 ± 10.6% (95% CI) when compared with the traditional one.
Conclusions:  Gustatory stimulants of salivary secretion with fluoride, xylitol and lower acid content maintain similar salivary stimulation capacity while reducing significantly the dental erosion predictive potential.     

Nutritional and vitamin status in patients with neuroendocrine neoplasms

Symptoms of gastroenteropancreatic located neuroendocrine neoplasms(GEPNENs) are often related to food intake and manifest as abdominal pain or diarrhoea which can influence patients nutritional status. Malnutrition is common in cancer patients and influences quality of life, treatment options and survival but is also present in up to 40% of patients with GEP-NENs. As part of malnutrition there are often deficiencies in fat-soluble vitamins, mainly vitamin D. Little knowledge exists on trace elements. Several factors influence the development of malnutrition such as size and localisation of the primary tumour as well as metastases, side effects from treatment but also hormone production of the tumour itself. One of the main influencing factors leading to malnutrition is diarrhoea which leads to dehydration and electrolyte disturbances. Treatment of diarrhoea should be guided by its cause. Screening for malnutrition should be part of routine care in every GEP-NEN patient. Multidisciplinary treatment including dietician support is necessary for all malnourished patients with GEP-NENs.     

Measurements and evaluations in low back pain patients

With the present review of literature, the authors intended to compare the definition terms, selection criteria, and measurement tools or methods used in different studies related to chronic low back pain (CLBP) patients. The relevance of including all the above information is that any health-care professional can use them to evaluate their treatment methods with CLBP patients or use them in study designs according to their objectives. These measurements concern pain measurements, measures that were used to describe the CLBP pain, questionnaires used to measure the CLBP patients' responses to pain, the pain effects on their living activities, and also measurements of the physical abilities and functional performance. A computerized literature search in English MEDLINE was conducted using "low back pain," and "flexibility, "strength,"evaluation,"functional level," and "measurements" as search words. Identified abstracts were scanned, and useful articles were acquired for further review. Interms of CLBP definitions, the authors concluded that is best defined as a lumbar, sacral, or lumbosacral spinal pain that is continuous or essentially continuous but low level punctuated by exacerbations of pain, each of which is characterized as "acute." In order to establish the criteria for selecting participants in a study design related to CLBP, pain characteristics and clinical diagnoses have to be taken into consideration for obtaining homogeneity of groups. Finally, the selection of measurement tools and evaluation methods is related to the study's goals, the specialization of the researchers, and their validity.     

Work-related risk factors for low back pain in firefighters. Is exercise helpful?

The aim of this study was to research the correlation between work-related physical risk factors and LBP pain and to examine the contribution of exercise among firefighters. In this study, a questionnaire survey was carried out among fully paid firefighters in Greece. Statistical analyses used were frequencies, Chi-square test and binary logistic regression. The study population consisted of 3,451 fully paid firefighters. Among the responders of the research, 30 % (n = 1,037) were reported to have LBP. There was a significant association between ‘job position’, ‘work time’ (years in current position), ‘weight lifting’, ‘exercise’, ‘age’, smoking, ‘gender’ and LBP (p < 0.05). The odds ratios (OR) of LBP were significantly greater: (a) in rescuers than in drivers, in comparison to officer firefighters; (b) in women than in men; (c) those who worked ‘more than 5 years’ than those working ‘between 1 and 5 years’; (d) those who do exercise ‘1–5 h per week’ than those doing exercise ‘more than 5 h/week’, in comparison to those who do ‘no exercise’, and those who lift more than 25 kg than those whose weight lifting is over 10 kg. In conclusion, improvements in job techniques and special exercise programs can contribute to the reduction of LBP symptoms in the future.     

Redox-sensitive events in Fas-induced apoptosis in human NK cells include ceramide generation and protein tyrosine dephosphorylation

We previously reported that intracellular oxidation-reduction (redox) regulates NK cell functions and that IL-2-activated NK cells undergo apoptosis upon contact with NK-sensitive target cells. We now report that apoptosis in activated human NK cells is also regulated by redox. Thiol deprivation increased apoptosis in NK cells induced by anti-Fas mAb or Fas ligand-transfected cells, and pretreatment of cells with N- acetyl cysteine, which increased intracellular glutathione, partially inhibited the apoptosis and reversed the effect of thiol-deficient medium, suggesting that Fas-induced apoptosis in NK cells is also redox sensitive. Thiol deprivation did not alter cell surface Fas expression, but did increase ceramide generation following Fas engagement. Although exogenous ceramides induced apoptosis of NK cells, thiol depletion had no effect on this apoptosis. Thiol deprivation increased CPP32 activation induced by Fas engagement, but not by ceramides. These findings suggest that, if ceramide is required for Fas-induced apoptosis, thiol deprivation affects the Fas-mediated signaling pathway at the generation of ceramide and/or upstream thereof. Though tyrosine phosphorylation following Fas engagement was not significantly affected by thiol deprivation, tyrosine dephosphorylation was delayed, suggesting that tyrosine phosphatases may also be redox sensitive. The notion that dephosphorylation is important in the Fas signaling pathway is supported by the finding that tyrosine phosphatase inhibitors significantly enhanced both CPP32 activity and apoptosis following Fas ligation. We conclude that events downstream of tyrosine phosphorylation and upstream of CPP32 activation, including tyrosine dephosphorylation and possibly ceramide generation, are sensitive to regulation by redox in human NK cells, requiring a reducing environment for optimal protection from apoptosis induced by Fas ligation.      

P_(16)蛋白在食管鳞状细胞癌的表达及临床意义

应用免疫络化S－P法检测88例食管浸润世鳞癌P16蛋白的表达，结果P16蛋白阳性率为55．68％（49/88），其阳性颗粒位于细胞浆内；组织学Ⅰ、Ⅱ、Ⅲ级阳性率分予的85．71％（18/21）、55.13％（16/29）、39.47％（15/38）（P＜0．01）；淋巴结转移组和无转移组阳世事分别为36.36％（12／33），67．27％（37／55）（P＜0．01）;3年生存率P16蛋白阳性组和阴性组分别36％和16．67％。结果表明食管鳞癌中P16蛋白的表达可以反映肿瘤的分化程度和转移情况．提示P16蛋白的检测可作为食管鳞癌的重要预后指标之一。     

Anti-spasmogenic effects of bencianol (ZY15051) on human cerebral arteries in vitro

Experiments were performed to assess the ability of bencianol (ZY15051) to reverse contractions of human basilar arteries in vitro that were induced by a wide range of substances implicated in the aetiology of migraine and cerebral arterial spasm. Bencianol caused a dose-related (1-100 micrograms ml-1) reversal of contractions induced by 5-hydroxytryptamine, noradrenaline, angiotensin II, prostaglandin F2 alpha, and U-46619 (a thromboxane-A2 mimetic). Bencianol was more effective against contractions induced by EC50 compared to maximal concentrations of each agent, and was least effective against the thromboxane-A2 mimetic, U-46619. In addition, contractions induced by thromboxane-A2-like substances generated from guinea-pig lungs were also reversed by bencianol but only at the highest concentration used (100 micrograms ml-1). The relevance of this action of bencianol to migraine and cerebral arterial spasm is discussed.     

Yoga lifestyle intervention reduces blood pressure in HIV‐infected adults with cardiovascular disease risk factors*

Objective

People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virological or immunological status, or quality of life (QOL) in HIV‐infected adults relative to standard of care treatment in a matched control group.

Methods

Sixty HIV‐infected adults with mild–moderate CVD risk were assigned to 20 weeks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were: 2‐h oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures, CD4 T‐cell count and plasma HIV RNA, and the Medical Outcomes Study Short Form (SF)‐36 health‐related QOL inventory.

Results

Resting systolic and diastolic blood pressures improved more (P=0.04) in the yoga group (−5 ± 2 and −3 ± 1 mmHg, respectively) than in the standard of care group (+1 ± 2 and+2 ± 2 mmHg, respectively). However, there was no greater reduction in body weight, fat mass or proatherogenic lipids, or improvements in glucose tolerance or overall QOL after yoga. Immune and virological status was not adversely affected.

Conclusion

Among traditional lifestyle modifications, yoga is a low‐cost, simple to administer, nonpharmacological, popular behavioural intervention that can lower blood pressure in pre‐hypertensive HIV‐infected adults with mild–moderate CVD risk factors.