Solving a bottleneck in animal models of peyronie＇s disease

Peyronie＇s disease is characterized by the formation of a fibrous plaque in the tunica albuginea （TA） of the penis. It is a benign condition of unclear etiology, resulting in deformities such as curvature, indentation or shortening. The disease has been shown to be prevalent, especially in older men, and affects quality of life, principally through pain during erection, erectile dysfunction and associated psychological impact.     

Surrogate Markers and Risk Factors for Chronic Lung Allograft Dysfunction

Obliterative bronchiolitis (OB) is the histologic correlate of chronic allograft dysfunction in pulmonary transplantation. The histologic diagnosis of OB is challenging, therefore a physiologic definition, bronchiolitis obliterans syndrome (BOS) based on pulmonary function tests has been used as a surrogate marker for OB for the last decade. BOS has proven to be the best available surrogate marker for OB and is predictive of the ultimate endpoints of graft and patient survival. Multiple other clinical markers have been reported and proposed as alternates for or complements to BOS grade, but all need further evaluation and validation in large, prospective clinical trials. Lastly, given the early occurrence and high incidence of chronic allograft dysfunction, the easily measurable endpoint of BOS grade, and our lack of understanding of ways to prevent or alter the course of BOS, lung transplant recipients represent an ideal population for clinical trials targeting prevention and treatment of chronic allograft dysfunction.     

Henoch-Sch?enlein syndrome in Qatar: the effects of steroid therapy and paucity of renal involvement.

This is a retrospective study of 40 patients admitted to Hamad General Hospital in the state of Qatar between January 1983 and December 1987 with the diagnosis of Henoch-Sch?enlein syndrome. Of the 40 patients, 25 were boys and 15 were girls, with a ratio of 1.6:1. Ages ranged from 2 years 3 months to 13 years, with a mean of 6 years. There were six episodes of recurrence in four patients. There was a clustering of cases in late summer and early winter. About half of the patients had a history of preceding upper respiratory infection. All of them had the typical skin rash. The percentages of joint, gastro-intestinal and renal manifestations were 80%, 65% and 17.39%, respectively. One patient had penile swelling which has not been reported before. Steroid therapy seemed to enhance early resolution of abdominal pain but did not affect the course of the syndrome. Sixty-seven per cent of the patients were followed up for from 4 weeks to 5 years, with a mean of 8 months. Only one patient with renal involvement continued to have proteinuria with microscopic haematuria and hypertension. The rest were normal within about 2 months. The remarkably low incidence of renal involvement in our study may be related to local variations in causative factors. Henoch-Sch?enlein syndrome is a milder disease in Qatar than in other countries.     

Antiheart antibodies following open heart surgery: incidence and correlation with postpericardiotomy syndrome.

One-dimensional sodium dodecyl sulphate polyacrylamide gel electrophoresis of myocardial proteins followed by Western blotting is a sensitive method for the detection of antiheart antibodies after cardiac transplantation. In a previous study we found that the majority of patients made antiheart antibodies after cardiac transplantation. It is possible that these antibodies were formed in response to cardiac damage caused during the surgical procedure rather than being specific to the transplantation situation. In this study we have evaluated the role of open cardiac surgery in the formation of antiheart antibodies for the first 9 months of the postoperative period using the Western blotting technique and correlated that with the development of post-pericardiotomy syndrome. Only 25% (9/36) of patients showed any increase in the pre-existing level of antiheart antibodies or developed antiheart antibodies with new reactivities. None of the patients in the study developed manifestations specific for post-pericardiotomy syndrome during the period of follow-up. The results support the contention that the high incidence of antiheart antibodies formed after cardiac transplantation is due to a humoral immune response to the presence of alloantigens on the grafted heart rather than as a result of the surgical procedure itself.     

A protocol for managing severe preeclampsia in the second trimester

One hundred nine patients with severe preeclampsia in the second trimester were studied. Pregnancy termination was recommended for those with gestational age less than or equal to 24 weeks (n = 25), whereas expectant management with aggressive maternal and fetal monitoring was recommended for those with gestational age greater than 24 but less than or equal to 27 weeks (n = 84). Ten of the 25 women in the early pregnancy group accepted termination and 15 elected to continue the pregnancy. The overall perinatal survival in the latter 15 patients was 6.7%, and maternal complications developed in six patients. Thirty of the 84 patients in the late second-trimester group had immediate delivery, and 54 had expectant management. The average length of pregnancy prolongation in the expectant group was 13.2 days (range, 4 to 28 days). Compared with the immediate delivery group, the expectant management group had significantly higher perinatal survival (76.4% versus 35%), significantly higher birth weights (880 versus 709 gm), and a lower incidence of neonatal complications. There were no differences between the two groups with regard to maternal complications. Expectant management with aggressive monitoring of maternal and fetal status at a perinatal center improves perinatal outcome in patients with severe preeclampsia with gestational age greater than 24 but less than or equal to 27 weeks.     

Supraventricular tachyarrythmia prophylaxis after coronary artery surgery in chronic obstructive pulmonary disease patients (early amiodarone prophylaxis trial).

OBJECTIVES: Supraventricular tachyarrhythmias (SVT) is common after coronary artery bypass grafting in chronic obstructive pulmonary disease (COPD). Preoperative FEV(1) is the major predetermining factor of mortality, morbidity and SVT. METHODS: Patients were divided into two groups according to their preoperative FEV(1) values. FEV(1) is <75% of predicted value in group 1 (no. 200), and >/=75% of predicted value in group 2 (no. 100). Group 1 is divided into two subgroups. SVT prophylaxis was not done in A subgroup (no. 100) whereas arrhythmia prophylaxis was done with amiodarone in all B subgroups (no. 100) in the early postoperative period. RESULTS: Atrial fibrillation developed in 28 patients in group 1A, whereas it developed in 12 in group 1B (P=0.005). Atrial flutter developed in 10 patients in group 1A but in 3 patients in group 1B (P=0.045). Multifocal atrial tachycardia developed in 13 patients in group 1A and in 4 in group 1B (P=0.022). Multivariate analysis identified ejection fraction (P<0.002, odds ratio (OR) 0.93), inotropy requirement (P<0.001, OR 3.98) amiodarone (P<0.001, OR 0.18), and FEV(1)<75% of predicted value (P<0.048, OR 1.84) as predictor of SVT. There were statistically significant differences between A and B subgroups of group 1 for hospital (P<0.001) and intensive care unit (ICU) stay (P<0.001). There was also statistically significant difference between groups 1A and 2 comparison for ICU (P<0.001; 6.4+/-3.4 versus 1.4+/-0.6 days) and hospital stay (P<0.001; 17.6+/-8.2 versus 6.9+/-0.6 days). CONCLUSIONS: Early prophylactic amiodarone not only significantly reduces SVT but also reduces SVT-related hospital and ICU stay. We strongly recommend prophylactic early use of amiodarone in COPD patients.