Three cases of bartonellosis (cat scratch disease)

In the last years the number of Bartonella species has conspicuously increased, with better clinical and diagnostic definitions of the different related illnesses. We report, in the present article, 3 cases of cat-scratch disease, a particular bartonellosis mainly caused by Bartonella henselae which is transmitted by the cat. After an incubation period, cat-scratch disease clinically manifests as a regional lymphoadenitis, with the appearance of a small cutaneous lesion at the site of inoculation of the germ. The pathogenetic agent is susceptible to a number of antibacterial agents, such as penicillin, cephalosporins, aminoglycosides, tetracyclines, macrolides, quinolones, trimethoprim combined with sulphamethoxazole and rifampicin. The prognosis is usually favorable.     

Male accessory gland infection frequency in infertile patients with chronic microbial prostatitis and irritable bowel syndrome: transrectal ultrasound examination helps to understand the links

The aim of this study was to evaluate the frequency of male accessory gland infection (MAGI) in patients with chronic bacterial prostatitis (CBP) plus irritable bowel syndrome (IBS) and to compare the sperm parameters of patients with or without MAGI. In addition, another objective of this study was to evaluate the ultrasound characterization of the anatomical space between the posterior wall of the prostate and the anterior wall of the rectum using transrectal ultrasonography. Fifty consecutive patients with the following criteria were enrolled: 1) infertility, 2) diagnosis of CBP, and 3) diagnosis of IBS according to the Rome III criteria. The following 2 age-matched control groups were also studied: infertile patients with CBP alone (n = 56) and fertile men (n = 30) who had fathered a child within the previous 3 months. Patients and controls underwent an accurate patient history; administration of the National Institutes of Health-Chronic Prostatitis Symptom Index and the Rome III questionnaires for prostatitis and IBS, respectively; physical examination; semen analysis; and transrectal ultrasound evaluation (limited to patients with CBP and IBS or CBP alone). A significantly higher frequency of MAGI was found in patients with CBP plus IBS (82.0%) compared with patients with CBP alone (53.6%) or fertile men (0%). The presence of MAGI in patients with CBP plus IBS was associated with a significantly lower sperm concentration, total number, and forward motility, and with a higher seminal leukocyte concentration compared with patients with CBP alone and MAGI. Sperm normal morphology was similar in the groups of patients. All sperm parameters did not differ significantly in both groups of patients without MAGI. With ultrasound evaluation, a significantly higher frequency of dilatation of prostatic venous plexus was found in patients with CBP plus IBS (75%) compared with patients with CBP alone (10%). Patients with CBP plus IBS had a significantly higher frequency of MAGI compared with patients with CBP alone. This was associated with worse sperm parameters and, hence, poorer reproductive prognosis. We suggest searching for the presence of IBS in patients with prostatitis syndrome, in particular when CBP and/or worse sperm parameters are present. Finally, this is the first observation on ultrasound examination of the anatomical space between the posterior wall of the prostate and the anterior wall of the rectum reported in patients with CBP and IBS. Further studies should clarify the meaning of the ultrasound findings.     

Circulating endothelial progenitor cells and endothelial microparticles in patients with arterial erectile dysfunction and metabolic syndrome

Blood endothelial progenitor cells (EPC) and microparticles (EMP) have been proposed as markers of endothelial dysfunction. The aim of this study was to evaluate both EPCs and EMPs in patients with arterial erectile dysfunction (ED) and metabolic syndrome (MetS). To accomplish this, 100 patients (ages 45-60 years) with ED and MetS (Adult Treatment Panel III [ATP III] 1999 criteria) and 17 healthy men (ages 44-57 years) were selected. EPC (CD45(neg)/CD34(pos)/CD144(pos)) and EMP (CD45(neg)/CD144(pos)/Annexin V(pos)) blood concentrations were evaluated by flow cytometry, before and after administration of tadalafil (20 mg) on demand for 3 months. Before treatment, EPCs and EMPs were significantly higher in patients compared with healthy men. EPCs increased significantly after tadalafil administration, whereas EMPs did not differ significantly. EPCs correlated positively or negatively with body mass index and with some cavernous artery indices, both before and after tadalafil administration. EMPs showed only positive correlations with body mass index and some cavernous artery indices, both before and after tadalafil administration. Patients with arterial ED and MetS have higher EPCs and EMPs compared with healthy men; hence, these cells may be regarded as markers of cavernous artery dysfunction. Tadalafil administration increased EPCs but not EMPs, suggesting that this compound may play a role in the endothelial repair response.     

Endothelial antioxidant compound prolonged the endothelial antiapoptotic effects registered after tadalafil treatment in patients with arterial erectile dysfunction

This study evaluated the effects of a chronic treatment with tadalafil, a specific phosphodiesterase V inhibitor, on endothelial apoptosis through changes in the serum concentration of endothelial microparticles (EMP). EMPs were arbitrarily chosen as a marker of endothelial apoptosis, and the changes in their concentration were monitored before and after treatment. Additionally, administration of endothelial antioxidant compound (EAC) during the follow-up, after discontinuation of tadalafil, was evaluated to determine whether this treatment improved the potential effects of tadalafil on the endothelium. Seventy-five patients with arterial erectile dysfunction were evaluated at baseline and after administration of tadalafil (5 mg once daily for 90 days). The International Index of Erectile Function questionnaire was administered, and penile dynamic Doppler and flow-cytometric (serum concentrations of EMPs) analyses were performed before (T0) and after treatment. Time points after tadalafil discontinuation: T1, after 1 week; T2, after 3 months; and T3, after 6 months. Three different schemes of follow-up were evaluated: group A, follow-up with EAC administration, after tadalafil discontinuation, for 6 months; group B, follow-up without other treatment; and group C, follow-up with placebo during the follow-up, after tadalafil cessation. The events CD45(neg)/CD144(pos)/annexinV(pos) were defined EMPs. Patients treated with tadalafil showed a significant decrease in serum EMPs 1 week after discontinuing tadalafil (16.4% ± 3.6% vs 7.1% ± 3.3%). This effect was maintained for up to 3 months in the group without other treatment during follow-up and was maintained for up to 6 months in the group treated with EAC during follow-up. Chronic treatment with tadalafil reduces endothelial apoptosis in patients with arterial erectile dysfunction. Further, EAC treatment prolongs and stabilizes the duration of antiapoptotic effects on the endothelium that are initially promoted by tadalafil treatment.     

Diabetes mellitus and sperm parameters

Because of the paucity of studies and inconsistencies regarding the impact of diabetes mellitus (DM) on semen quality, this disease is seldom looked for in the infertile patient. Recently, this view has been challenged by findings showing that DM induces subtle molecular changes that are important for sperm quality and function. This brief review shows the main sperm parameters in patients with DM and presents the mechanisms hypothesized to explain the changes observed in these patients. The data available suggest that DM alters conventional sperm parameters. In addition, DM causes histologic damage of the epididymis, with a negative impact on sperm transit. Various mechanisms may explain the sperm damage observed in patients with DM. These include endocrine disorders, neuropathy, and increased oxidative stress. Many authors suggest that DM decreases serum testosterone levels. This is associated with a steroidogenetic defect in Leydig cells. In addition, diabetic neuropathy seems to cause atonia of seminal vesicles, bladder, and urethra. Furthermore, DM is associated with an increased oxidative stress, which damages sperm nuclear and mitochondrial DNA. Finally, spermatogenesis derangement and germ cell apoptosis in type 1 DM may relate to a local autoimmune damage, whereas insulin resistance, obesity, and other related comorbidities may impair sperm parameters and decrease testosterone serum levels in patients with type 2 DM.     

Hyperviscosity of semen in patients with male accessory gland infection:direct measurement with quantitative viscosimeter

The aim of this study was to evaluate whether the viscosity of semen in patients with male accessory gland infection is related to the extension of the inflammatory process to the various glands. To achieve this, viscosity was assessed by quantitative viscosimeter and the results were expressed in centipoise (cps). The study was conducted on 30 infertile patients with clinical evidence of male accessory gland infection and a mean age of 29.0 ± 4.0 years. Their semen viscosity was evaluated through quantitative viscometer. All patients showed an increase of viscosity evaluated according to WHO criteria, while this parameter was normal in all controls. Semen viscosity of patients with male accessory gland infection (28.6 ± 2.2 cps) was significantly (P < 0.05) higher than that in the controls (10.7 ± 0.6 cps). Significantly increasing values were observed in patients with involvement of multiple gland inflammation (prostatitis 相似文献   

Information management and complementary alternative medicine: the anatomy of information about CAMs through PubMed

In recent years, there has been a growing interest about complementary and alternative medicine (CAM), and the use of CAM interventions has become more common among people. For these reasons, health professionals must be able to effectively manage information in this field of knowledge according to an evidence-based point of view. This study assessed the anatomy of the available information about CAMs using PubMed, to give practical instructions to manage information in this field. We also analyzed the anatomy of information according to each alternative medicine branch, narrow and broad search methods, subset filters for indexed-for-Medline and non-indexed citations, and different publication types including randomized controlled trials (RCTs) and meta-analyses. Our results demonstrated that the use of CAMs subset (supplied by PubMed search engine) leads to a great number of citations determining an information overload. Our data reveal that it would be more useful to search for the CAM separately, identifying specific items and study design. Moreover, we found the largest number of randomized clinical trials and meta-analyses related to herbal medicine and acupuncture, neither RCTs nor meta-analyses were available for bach and flower remedies, auriculoacupuncture, iridology, and pranotherapy. For the first time, our study gives a comprehensive view of the anatomy of information regarding CAMs and each branch of them. We suggest a methodological approach to face with searching information about this emerging issue from an evidence-based point of view. Finally, our data pointed out some “grey zones” since neither RCTs nor meta-analyses were available for some CAMs.