Influence of pain and urinary symptoms on quality of life in young men with chronic prostatitis-like symptoms

BACKGROUND: Our aims in the present study were to estimate the influences of pain and urinary symptoms on quality of life, and to determine which of these two variables has the most predictive power with respect to quality of life in young men with chronic prostatitis-like symptoms. METHODS: Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. Of the 28,841 men aged 20 years who lived in the study community, 18,495 men (a response rate 64.1%) agreed to participate in the study. A total of 1057 men who complained of symptoms indicative of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined using logistic regression analysis. The receiver operating characteristic (ROC) curve was used to estimate the predictive ability of each of these variables with respect to quality of life. RESULTS: Results from multivariate analysis showed that both pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, although pain contributed more to a reduced quality of life than urinary symptoms. Relative to men who experienced mild pain, men who experienced moderate pain had a 3.9-fold risk of poor quality of life (odds ratio [OR], 3.87; 95% confidence interval [CI], 2.86-5.23; P < 0.001) and those who experienced severe pain had a 15.7-fold risk of reduced quality of life (OR, 15.68; 95% CI, 6.59-37.35; P < 0.001). Moderate urinary symptoms were associated with a 1.4-fold risk of bother (OR, 1.41; 95% CI, 1.01-1.99; P < 0.001) and severe urinary symptoms were associated with 2.4-fold risk (OR, 2.39; 95% CI, 1.37-4.12; P < 0.001), relative to mild urinary symptoms. Comparison of the effects of pain and urinary symptoms showed that pain severity had the most predictive power for bother, quality of life, and quality-of-life impact. The areas under the ROC curves for bother, quality of life, and quality-of-life impact were 71.3%, 69.3% and 72.5%, respectively. CONCLUSION: Urinary symptoms and pain might be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influential variable for determining quality of life in this population.     

Retroviruses and schizophrenia in Jamaica

Reports of an 18-fold higher incidence of schizophrenia among second-generation Afro-Caribbeans, and especially Jamaican migrants in the United Kingdom were soon called “an epidemic of schizophrenia,” with the inference that a novel virus, likely to be perinatally transmitted, was a possible etiological agent. This intriguing observation led us to explore a possible link with human T-cell lymphotropic virus type one (HTLV-I), because it is a virus that is endemic in the Caribbean Islands, is perinatally transmitted, known to be neuropathogenic, and the cause of a chronic myelopathy (tropical spastic paraparesis/ HTLV-I associated myelopathy). We therefore examined inpatients at the Bellevue Mental Hospital, Kingston, Jamaica and did standard serological tests for retroviruses HTLV-I and HTLV-II and HIV-I and HIV-II on 201 inpatients who fulfilled ICD-9 and DSM III-R criteria for schizophrenia. Our results produced important negative data, since the seropositivity rates for HTLV-I, the most likely pathogen, were no greater than the seropositivity range for HTLV-I carriers in this island population, indicating that HTLV-I and the other retroviruses tested do not play a primary etiological role in Jamaican schizophrenics.     

Cytochemical localization of Mn2+-dependent pyrimidine 5'-nucleotidase activity in isolated rod outer segments

A cytochemical method was developed for localization in isolated rod outer segments of manganese-dependent pyrimidine 5'-nucleotidase (MDPNase), an enzyme activity with possible relevance to shedding that we recently reported in photoreceptors and retinal pigment epithelial (RPE) cells in the intact rat retina. The purpose of this study was to eliminate the possibility that the previously observed cytochemical staining of the rods was due to diffusion of reaction product from the RPE cell lysosomes, which were also heavily stained. Rod outer segments (ROS) were isolated on continuous sucrose gradients from retinal homogenates prepared from rats raised in cyclic light (12 hr light:12 hr dark) and killed during the first 2 hr after light onset. ROS-containing bands were removed from the gradients and the isolated rods were fixed in 0.25% glutaraldehyde and pelleted. Chopped sections of the pellets were incubated in cytochemical medium for MDPNase activity and processed for light- and electron-microscopic localization of the enzyme activity. Two patterns of cytochemical staining were seen in ROS isolated from retinas obtained at this time of day. A few of the pellets contained clusters of ROS that were heavily coated along their surfaces and seemingly interconnected by thick strands of highly reactive extracellular material that displayed a punctate pattern of cytochemical staining. This material may have originated from the apical processes of the RPE cells, which were heavily stained in tissue fixed in situ around the time of light onset. The second staining pattern, visible only by electron microscopy, was more commonly observed. In the majority of the isolated ROS profiles, discrete streaks of cytochemical reaction product were seen in association with the internal aspects of the discs, at sites that seemed to correspond to the rims, and to narrow zones within the disc interiors. This distribution of reactive sites closely resembled that observed over most of the length of the ROS in the intact retina fixed at the same time of day. Occasionally, ROS profiles were encountered in which additional reactive sites were localized to the interdisc spaces between the plasma membrane and the rims of the discs. The latter pattern resembled the distribution of reaction product seen during this period over the tips of the ROS fixed in situ. As in the intact retinas, the cytochemical staining of the isolated ROS was inhibited by fluoride ions and strongly stimulated by manganese ions.(ABSTRACT TRUNCATED AT 400 WORDS)