The effect of chronic exogenous androgen on myocardial function following acute ischemia-reperfusion in hosts with different baseline levels of sex steroids

BACKGROUND: Gender differences exist in the myocardial response to acute ischemia/reperfusion (I/R) injury and may be attributed to the effects of the sex hormones estrogen and testosterone. The role of estrogen in myocardial injury has been extensively studied but little information exists regarding the myocardial involvement of testosterone. Based on the deleterious effects of chronic endogenous and acute testosterone exposure observed in our previous studies, we postulated that chronic exogenous testosterone administration would also exhibit deleterious effects on myocardial function following I/R. METHODS: Langendorff perfused rat hearts were subjected to 25 min ischemia, 40 min reperfusion, and left ventricular developed pressure (LVDP) was recorded. Control and 5alpha-dihydrotestosterone (DHT) treated groups each consisted of normal males, castrated males, ovariectomized (OVX) females, and senescent females. P < 0.05 = significant. RESULTS: Chronic DHT replacement therapy showed no difference in functional ischemic recovery as measured by LVDP after 40 min reperfusion in castrated males (65.1 +/- 8.13% versus 66.3 +/- 4.54%), OVX females (64.5 +/- 10.6% versus 50.2 +/- 5.97%), and senescent females (42.1 +/- 0.04% versus 41 +/- 0.05%). Interestingly, LVDP was greater in DHT treated males than control males after I/R (65.2 +/- 8.20% versus 47.6 +/- 5.19%). Also, DHT treatment resulted in significantly increased recovery of LVDP after only 10 min reperfusion in castrated males, OVX females, and senescent females compared with their untreated counterparts (54.8 +/- 11.9% versus 32.9 +/- 5.75%, 66.7 +/- 11.5% versus 43.1 +/- 8.15%, 53.4 +/- 10.1% versus 32.9 +/- 5.75%, respectively). CONCLUSION: Contrary to the adverse effects we observed in earlier studies with both endogenous and brief exogenous testosterone in myocardium injured by I/R, the present study revealed that chronic exogenous testosterone neither improved nor worsened myocardial functional recovery following 25 min ischemia and 40 min reperfusion.     

Creation of continence mechanisms (Mitrofanoff) without appendix: the Monti and spiral Monti procedures

This is a review of the technique to create a continent catheterizable stoma using the Yang-Monti principle of a transversely tubularized segment of bowel. Pediatric urologists have widely used this technique for years, especially when the appendix is either not available or suitable for use. It provides the surgeon with a reliable, predictable, and durable method for creating a continent catheterizable channel. The indications for its use, principles of construction, and outcomes in a large population of children are described.     

A conceptual framework for the social analysis of reproductive health

The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis.     

Factors associated with mortality in a cohort of Australian prisoners

We examined factors associated with increased mortality in a cohort of 85,203 adults with a history of imprisonment in New South Wales, Australia, between 1988 and 2002. Information on death was collected through linkage to the Australian National Death Index. The influence of demographic and criminological factors on the standardised mortality ratio (SMR) for all-cause mortality, and deaths due to drug overdose and suicide was examined using negative binomial regression models. The number of deaths identified was 5,137 (4,714 men, 423 women, 303 in custody). The overall SMR was 3.7 (3.6–3.8) in men and 7.8 (7.1–8.5) in women. SMRs raised for deaths due to drug overdose (men: 12.8, women: 50.3) and suicide (men: 4.8, women: 12.2). The high SMR was associated with hospitalisation for mental illness, multiple imprisonments, and early stage of follow-up independently of causes of death. Being released from prison increased the SMRs for all-cause and drug-related mortality, but not suicide. For women, significant trends for decreasing risk with increasing age were noted. Minority groups, in particular men, had a lower risk of death than white people. In men a sex or drug offence was associated with a lower risk and a property or violence offence was related to higher mortality. Our results reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Certain demographic and imprisonment characteristics are indicators of high mortality among this population. The underlying causes of some of these characteristics such as mental illness or multiple imprisonments are potentially treatable and preventable. Prison health services need to develop interventions targeting high-risk groups to avoid this situation.     

Nasality in Friedreich ataxia

Perceptual speech research in Friedreich ataxia (FRDA) has identified altered nasality as a key component of the dysarthria profile, however the incidence and severity of abnormal nasality remains unknown. Utilizing objective and perceptual methods, data on the relationship between resonance, disease duration, severity, age of onset and genetic profiles were collated. Thirty-seven participants with FRDA and 24 healthy controls provided contemporaneous speech samples for perceptual analysis, and single word samples for acoustic analysis. A subset of participants (eight participants with FRDA and eight controls) underwent nasometry assessment. Twenty-seven participants with FRDA presented with hypernasality and five with hyponasality on perceptual assessment. Acoustic analysis revealed participants with FRDA had greater nasality than controls (p?ρ?=?0.37, p?=?0.03). Findings highlight the variability of nasality in FRDA, potentially reflecting variation in the neuropathological profile. Data also suggest the influence of genetic profiles on nasality.     

Spectral measures of the effects of Friedreich's ataxia on speech

This study identifies two measures of the effects of Friedreich's ataxia (FRDA) on speech motor control. Speech samples of 17 healthy controls and 37 speakers with dysarthria associated with FRDA were recorded during one structured and one unstructured speaking task. Two measures of spectral variation were used that relate to the rate and range of changes that occur in the spectral envelope. Linear mixed models revealed significant effects of GROUP, TASK, and GROUP*TASK. FRDA speech samples had slower rate of spectral change and reduced spectral range. Healthy speakers produced faster rates of spectral change in read text compared to conversation, but speakers with dysarthria did not. The results suggest that structured speaking tasks which demand large spectral variation may be particularly useful in assessing the dysarthria. It is concluded that the rate of spectral change is a useful measure of dysarthria associated with FRDA.