Depression, Testosterone Concentration, Sexual Dysfunction and Methadone Use Among Men with Hypogonadism and HIV Infection

Low testosterone levels are associated with depression and impaired sexual performance. We examined the association between hypogonadism, sexual function and depression among men with HIV infection in Shiraz, Iran. A total of 237 male HIV-positive patients referred to voluntary counseling centers were recruited based on convenience sampling from May to October 2010. All patients provided informed consent and completed the Beck Depression Inventory (BDI-II) and Brief Male Sexual Function Inventory (BMSFI). Blood samples were collected after an overnight fast to measure free testosterone (FT) concentration. Hypogonadism was found in 68?% of the participants, and about 68.8?% had moderate and severe depression. Serum FT levels were significantly lower in patients with depression and a direct association was found between the risk of hypogonadism and increased BDI-II score. Among methadone nonusers and nondepressed patients, an inverse association was found between hypogonadal and eugonadal men in the sexual drive, erectile and ejaculatory function domains of the BMSFI. However, there was no significant association between methadone user status and depression. Depression and hypogonadism had a reciprocal effect. Depression and methadone use were associated with hypogonadism and had a significant effect on sexual function.     

Low dose ribavirin for treatment of hepatitis C virus infected thalassemia major patients; new indications for combination therapy

Background

Treatment guidelines contraindicate ribavirin for treatment of hepatitis C virus (HCV) infection in thalassemia major patients. Nevertheless, the current evidence suggests that ribavirin might be tolerated by these patients.

Objectives

Despite this evidence, low dose ribavirin combination therapy has not been compared with peginterferon monotherapy in these patients so far.

Patients and Methods

Two hundred eighty thalassemia patients with detectable HCV-RNA PCR (≥ 50 IU/mL) and liver histology consistent with chronic HCV infection were self-assigned to receive peginterferon alfa-2a (n = 81) monotherapy or its combination therapy with ribavirin, 600-800 mg QD, according to hemoglobin levels (n = 199). Treatment experienced patients were eligible for this study.

Results

Sustained virological response (SVR) was significantly higher in patients who received ribavirin (51 % vs. 38 % P = 0.02). In multivariate regression, OR of ribavirin for prediction of SVR was 2.2 (95 % CI 1.24-3.91). The SVR was significantly higher in the ribavirin group in subgroups of patients with more than 24 years of age, elevated ALT, ferritin < 2006 ng/mL, previous treatment failure, genotype 1, positive history of splenectomy, fibrosis score of 0-4 HAI and viral load < 600,000 IU/mL. Treatment discontinuations due to the safety concerns were comparable between the treatment groups (6.5 and 8 %). Furthermore, transfusion intervals were almost halved in patients who received low dose ribavirin.

Conclusions

According to the present study, adult thalassemia patients with HCV infection can be treated successfully with low dose ribavirin. Hence, we strongly advise combination therapy in thalassemia patients with aforementioned clinical characteristics. Moreover, ribavirin does not seem to be beneficial in thalassemia patients below 18 years of age.     

Recent trends in the direct oxyphosphorylation of C–C multiple bonds

Due to the wide importance of β-phosphorylated ketones as key building-blocks in the fabrication of various pharmaceutically active organophosphorus compounds, finding new and truly efficient methods for their preparation from simple, low-cost and ubiquitous feedstock materials within a single click is an interesting subject in organic synthesis. Recently, oxyfunctionalization of carbon–carbon multiple bonds has arisen as a straightforward and versatile tool for the synthesis of complex organic molecules from the simple and easily accessible alkenes/alkynes via a single operation. In this context, oxyphosphorylation of alkenes/alkynes with P(O)–H compounds has attracted considerable attention as a unique procedure for the construction of β-phosphorylated ketones. In this review, we outline the recent advances and developments in this fast-growing research field with particular emphasis on the mechanistic aspects of reaction.

Due to the wide importance of β-phosphorylated ketones as key building-blocks in the fabrication of various pharmaceutically active organophosphorus compounds, finding new and truly efficient methods for their preparation.     

The Prognostic Value of Varying Definitions of Positive Resection Margin in Patients with Colorectal Cancer Liver Metastases

Background

Varying definitions of resection margin clearance are currently employed among patients with colorectal cancer liver metastases (CRLM). Specifically, a microscopically positive margin (R1) has alternatively been equated with an involved margin (margin width?=?0 mm) or a margin width <?1 mm. Consequently, patients with a margin width of 0–1 mm (sub-mm) are inconsistently classified in either the R0 or R1 categories, thus obscuring the prognostic implications of sub-mm margins.

Methods

Six hundred thirty-three patients who underwent resection of CRLM were identified. Both R1 definitions were alternatively employed and multivariable analysis was used to determine the predictive power of each definition, as well as the prognostic implications of a sub-mm margin.

Results

Five hundred thirty-nine (85.2%) patients had a margin width ≥?1 mm, 42 had a sub-mm margin width, and 52 had an involved margin (0 mm). A margin width ≥?1 mm was associated with improved survival vs. a sub-mm margin (65 vs. 36 months; P?=?0.03) or an involved margin (65 vs. 33 months; P?<?0.001). No significant difference in survival was detected between patients with involved vs. sub-mm margins (P?=?0.31). A sub-mm margin and an involved margin were both independent predictors of worse OS (HR 1.66, 1.04–2.67; P?=?0.04, and HR 2.14, 1.46–3.16; P?<?0.001, respectively) in multivariable analysis. Importantly, after combining the two definitions, patients with either an involved margin or a sub-mm margin were associated with worse OS in multivariable analysis (HR 1.94, 1.41–2.65; P?<?0.001).

Conclusions

Patients with involved or sub-mm margins demonstrated a similar inferior OS vs. patients with a margin width >?1 mm. Consequently, a uniform definition of R1 as a margin width <?1 mm should perhaps be employed by future studies.

     

Non-syndromic hypodontia in an Iranian orthodontic population

To investigate the prevalence, characteristics (ie, malocclusion, location, type), and sex distribution of hypodontia in an Iranian orthodontic population. A retrospective study was conducted using periapical and panoramic radiographs and study models of 1,751 subjects attending university orthodontic clinics (870 females, 881 males, age 9-27 years). The Chi-square test was used to analyze differences in the distribution of hypodontia, after stratification by sex and malocclusion type. A total of 197 congenitally missing teeth were observed in 160 patients (9.1%; 74 boys and 86 girls); there were no statistically significant differences between sexes (Chi-square = 0.832, P = 0.36). Hypodontia was more common in patients with Class III malocclusion (45.2%), and was more prevalent in the maxilla (71%) than in the mandible (29%). Maxillary lateral incisors (35.6%) and maxillary second premolars (13.0%) were the most commonly missing teeth, followed by mandibular lateral incisors (9.6%) and mandibular second premolars (8.2%). The prevalence of missing teeth was higher in the anterior segment (incisors and canines) than in the posterior segment (premolars and molars). The prevalence of oligodontia was 0.34%. The prevalence and characteristics of the most frequently missing teeth accorded with the findings of most studies conducted in other countries.     

Evaluation of the protective effect of pentoxifylline on carrageenan-induced chronic non-bacterial prostatitis in rats

Chronic non-bacterial prostatitis (CNP) is the most common type of prostatitis and oxidative stress (OS) was shown to be highly elevated in prostatitis patients. This study aimed to investigate the protective effect of pentoxifylline (PTX) on CNP induced by carrageenan in rats. Male adult Wistar rats (n = 30) were divided into control, CNP and three treatment groups (n = 6) including CNP + cernilton and CNP + PTX groups. CNP was induced by single intraprostatic injection of 1% carrageenan (100 µl). Rats in treatment groups received orally cernilton 100 mg/kg and PTX at 50 and 100 mg/kg 1 week after CNP induction for 21 days. Prostatic index (PI), prostatic specific antigen (PSA), tumor-necrosis factor alpha (TNF-α), serum lipid peroxidation (MDA), blood urea nitrogen, creatinine and histopathological changes were compared between groups. There were significant increase of PI, serum levels of PSA, TNF-α and MDA in CNP group at 29 day. In treatment groups, significant reduction in PI, serum levels of PSA, TNF-α, MDA and creatinine was observed especially in rats treated with dose of 50 mg/kg of PTX. In CNP group, histopathological changes of the prostate such as leucocyte infiltration, large involutions and projection into the lumen and reducing the volume of the lumen were observed as well. Whereas PTX, especially at dose of 50 mg/kg, could improve the above-mentioned changes remarkably in CNP treated rats. For the first time, our findings indicated that PTX improved CNP induced by carrageenan in rats.     

Wear and abrasion resistance selection maps of biological materials

The mechanical design of biological materials has generated widespread interest in recent years, providing many insights into their intriguing structure–property relationships. A critical characteristic of load-bearing materials, which is central to the survival of many species, is their wear and abrasion tolerance. In order to be fully functional, protective armors, dentitious structures and dynamic appendages must be able to tolerate repetitive contact loads without significant loss of materials or internal damage. However, very little is known about this tribological performance. Using a contact mechanics framework, we have constructed materials selection charts that provide general predictions about the wear performance of biological materials as a function of their fundamental mechanical properties. One key assumption in constructing these selection charts is that abrasion tolerance is governed by the first irreversible damage at the contact point. The maps were generated using comprehensive data from the literature and encompass a wide range of materials, from heavily mineralized to fully organic materials. Our analysis shows that the tolerance of biological materials against abrasion depends on contact geometry, which is ultimately correlated to environmental and selective pressures. Comparisons with experimental data from nanoindentation experiments are also drawn in order to verify our predictions. With the increasing amount of data available for biological materials also comes the challenge of selecting relevant model systems for bioinspired materials engineering. We suggest that these maps will be able to guide this selection by providing an overview of biological materials that are predicted to exhibit the best abrasion tolerance, which is of fundamental interest for a wide range of applications, for instance in restorative implants and protective devices.     

Correlation between capillary and arterial blood gas parameters in an ED

Background and aims

Sampling from arteries for the analysis of blood gases is a common procedure in emergency departments (ED). The procedure is painful for the patients and causes concern for the medical personnel due to possible complications, such as hematoma, infection, ischemia, and formation of fistula or aneurism. The present study compared the results of capillary and arterial blood gases analyses (CBG and ABG) to emphasizing a less aggressive technique with the fewest complications for this procedure.

Materials and methods

In the comparative/analytical study, the results of ABG and CBG for 187 patients referring to the ED of a teaching hospital were compared using SPSS 18 statistical software (SPSS, Chicago, IL) in relation to the mean partial pressure of oxygen (Po₂), partial pressure of carbon dioxide (Pco₂), base excess (BE), bicarbonate (HCO₃), serum acidity (pH), and saturation of hemoglobin oxygen (SaO₂).

Results

Saturation of hemoglobin oxygen, HCO₃, pH, Pco₂, Po₂, and BE exhibited significant statistical correlation between ABG and CBG (P = .001). The average correlations between capillary and arterial samples were 0.78 for pH, 0.73 for Pco₂, 0.71 for BE, 0.90 for HCO₃, 0.77 for Po₂, and 0.52 for SaO₂. Comparison of the parameters means did not exhibit significant differences between arterial and capillary samples except for Po₂ and SaO₂ (P > .05).

Conclusion

There appear to be strong correlation between samples collected from the finger tip capillaries with the arterial blood samples in relation to the analysis of blood gas.     

An improved technique for increasing the accuracy of joint-to-ground distance tracking in kinect v2 for foot-off and foot contact detection

The Kinect sensor has been widely used in different applications such as rehabilitation and gait analysis. Whilst Kinect v2 was released with several improvements over its predecessor, it still incorporates depth-map intrinsic inaccuracies. This results in inconsistencies in skeletal-data acquisition, especially in joint localisation and distance-to-ground tracking with respect to the Kinect’s 3-D Cartesian coordinate reference point. This research proposes a correction technique based on the two-point linear equation derived from the information gathered from different subjects’ skeletal data and data regression analysis to compensate the inaccuracies in joint-to-ground data collection. The research also proposes a new footsteps detection method based on skeletal data and plane detection techniques that calculates a footstep by using the ankle’s Euclidean distance from the floor, regardless of the subject’s distance from the camera. The results show that after the correction technique was applied, data acquisition proved to be consistent and more accurate within a distance range of 1.6–2.9 m from the Kinect camera, regardless of the subject’s location to the camera’s reference point. Moreover, the inconsistency of joint data read by the Kinect was reduced from 25.69% to 5.25% and the footsteps detection accuracy increased from 42.85% to 79.76% on average for both legs.