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Biomedical subjects

D Canale

Publications and source records attributed to D Canale.

At least 19 recordsLinked to original sources

Serum PSA levels are not affected by the menstrual cycle or the menopause, but are increased in subjects with polycystic ovary syndrome.

BACKGROUND/AIMS: Prostatic specific antigen (PSA) is the most specific prostatic tumor marker in man. Recently, PSA has been detected in a variety of tissues and fluids in women, and its determination suggested as a marker of hyperandrogenism. However, precise information about the physiology of PSA in females is not available. The goal of this study was to assess serum concentrations of PSA in healthy pre-menopausal women (healthy pre-menopausal group), menopausal women (menopause group) and patients with polycystic ovary syndrome (PCOS group). METHODS: PSA, androgens, LH, FSH, 17-beta-estradiol (E2), progesterone (Pg) were assessed in 40 post-menopausal women, 35 fertile controls and 35 women with PCOS. RESULTS: No significant difference in PSA concentrations could be demonstrated in different phases of the menstrual cycle in healthy pre-menopausal group and between pre- and post-menopausal groups. No correlations could be demonstrated between serum PSA levels and the following parameters: age, body mass index (BMI), LH, FSH, E2, testosterone (T), DHEAS, and SHBG, both in pre- and post-menopausal women. Significantly higher PSA levels (median=14 pg/ml) were found in the PCOS group compared to both pre-menopausal (median=5 pg/ml) and menopausal (median= 5 pg/ml) groups (p< 0.05). CONCLUSIONS: only minor fluctuations of serum PSA concentrations are observed in healthy pre- and post-menopausal women, while serum level is higher in PCOS, and therefore PSA can be considered a suitable marker of female hyperandrogenism.

Adult↗

Androgen receptor polymorphism (CAG repeats) and androgenicity.

Objective Polymorphism of the androgen receptor (AR) has been related to various pathophysiological conditions, such as osteoporosis and infertility. The objectives of this study were to evaluate the frequency of distribution in a normal Italian population and to assess CAG repeats (CAGr) in other conditions, such as hypoandrogenism, potentially influenced by AR polymorphism. Patients and measurements CAGr polymorphism was determined in a group of 91 healthy normoandrogenized subjects, 29 hypoandrogenized patients (hypoplasia of prostate and seminal vesicles, reduced beard or body hair, etc.) and 29 infertile patients by direct sequencing. Results The mean (+/- SD) number of CAG repeats [(CAGr)n] was 21.5 (+/- 1.7) in the control group, 21.4 (+/- 2.0) in the infertile patients and 24.0 (+/- 2.9) in the hypoandrogenic males. The difference was statistically significant between this last group and the other two (P < 0.0001), while there was no difference between normal controls and infertile patients. The frequency distribution showed a shift towards higher CAG length in hypoandrogenized patients compared to controls and infertile patients. If we used a cut-off point of 24.9 (2 SD above the mean), the percentage of patients with 25 or more CAGr repeats was 38% among hypoandrogenized patients, 7% among infertile patients and 5% among the control group. In hypoandrogenized subjects (CAGr)n correlated slightly with testis and prostate volume. The number of CAG repeats was not associated with any of the hormonal parameters, including testosterone, evaluated in the three groups. Conclusions Our normal population, representing subjects from Central Italy, is superimposable on other European populations with regard to (CAGr)n distribution. Hypoandrogenic males have a shift in the frequency distribution towards longer (CAGr)n. Infertile patients are not statistically different from the control group. These findings suggest that, given the same amount of circulating testosterone, as in our hypoandrogenized and control group, the final net androgenic phenotypical effect is due to AR polymorphism.

Adult↗

Effects of hormonal replacement treatment on bone mineral density and metabolism in hypogonadal patients.

We investigated 22 male patients affected by prepubertal hypogonadism with a mean age of 34.3+/-5.2. A significant reduction of bone mineral density (BMD) at both the lumbar spine (L2-L4, -14%, 1.039+/-0.11 vs. 1.217+/-0.16 g/cm(2), P=0.005) and femoral neck (-11%; 0.927+/-0.09 vs. 1.034+/-0.16 g/cm(2), P=0.01) was found in patients compared to age-matched controls. The mean Z score was -1. 55 for vertebrae and -1.33 for femur. Eleven and nine patients, respectively, had a lumbar and femoral BMD at least 1 S.D. below the normal mean; 8 and 4, respectively, 2 S.D. below. There was a strong positive correlation between BMD and duration of hormone replacement treatment (HRT) for both sites: respectively, r=0.71, P<0.005 for the vertebrae, and r=0.60, P<0.01 for the femur. A weak correlation was also present between onset of HRT and BMD: r=0.6, P<0.01 at the lumbar level, and r=0.47, P<0.05 at the femoral neck.

Adult↗

Breakpoint of a Y chromosome pericentric inversion in the DAZ gene area. A case report.

BACKGROUND: The presence of a spermatogenesis locus (gene or gene complex) in the euchromatic region of the long arm of the Y chromosome (Yq11), defined as azoospermia factor on the basis of gross structural rearrangement, was detected. The gene family responsible for different spermatogenetic defects is "deleted in azoospermia" (DAZ). CASE: A 34-year-old man had oligozoospermia, and a cytogenetic analysis carried out on peripheral lymphocytes with G banding revealed a 46,X, inv(Y)(p11q11)karyotype. The relation between the chromosomal breakpoint and the DAZ gene was more precisely defined by a fluorescent in situ hybridization technique. We revealed two signals for the DAZ gene, weaker than normal, one on the short arm and the other on the long arm of the Y chromosome, indicating that the breakpoint was located at the DAZ gene level. CONCLUSION: This is the first report documenting a chromosomal pericentric inversion with disruption in the DAZ gene area. We hope to obtain information on whether the disruption affects a functional zone of the gene and correlates with oligospermia at the chromosomal level.

Adult↗

Detection of a new de novo mutation at codon 251 of exon 8 of thyroid hormone receptor beta gene in an Italian kindred with resistance to thyroid hormone.

Resistance to thyroid hormone (RTH) is almost invariably associated with mutations of the thyroid hormone (TH) receptor beta (hTR beta) gene and is inherited as an autosomal dominant disease. Mutations of hTR beta identified in patients affected by RTH cluster generally at two spots of the ligand binding domain. We investigated whether an Italian kindred with RTH had a mutation in the thyroid hormone (TH) receptor beta gene. Blood samples were obtained from the available family members for biochemical and genetic analyses. Thyroid function tests in basal conditions, and in the case of the propositus also following incremental doses of T3, were performed. Exon 4 to 10 of hTR beta gene were amplified using the polymerase chain reaction (PCR) and the mutation was identified by direct sequence analysis. The affinity constant of this mutated receptor for T3 was measured by in vitro transcription-translation and was then compared with that of wild type. We identified a heterozygous G to A transition at nucleotide 1037 of exon 8 at codon 251, resulting in a glycine (G) to glutamic acid (E) substitution (G251E) in the patient affected by RTH and in his affected offspring, but not in the normal family members. This novel mutation represents a de novo mutation since both parents of the index case were unaffected and did not have this genomic mutation. When expressed in vitro, the mutant protein (G251E) showed a marked decrease of the affinity for T3, suggesting an impaired ligand-dependent transactivation activity of this mutant receptor. In vivo studies with incremental doses of L-T3 demonstrated a reduced sensitivity to TH in the index case, in particular at the pituitary level where the thyrotrophs' activity was not completely inhibited even by 200 micrograms/day of L-T3. G251E mutation represents the fourth mutation described up to now in exon 8 of hTR beta among the subjects affected by RTH. A third cluster of mutations of the c-erbA beta gene located proximally with respect to the other two so far described begins to emerge in RTH patients.

Adult↗

The role of the peridomiciliary area in the elimination of Triatoma infestans from rural Argentine communities.

The purpose of this study was to identify the origin of Triatoma infestans reinfestation and study its dynamics following spraying with deltamethrin inside and around 94 houses in three rural communities in northwestern Argentina. The effectiveness of the spraying was evaluated immediately after the houses were sprayed and two months later. In addition, five residual peridomiciliary foci were found and sprayed, as well as three preexisting ones that had not been sprayed. To monitor reinfestation, biosensors were placed in the houses and each family was also asked to capture triatomines and keep them in plastic bags; in addition, triatomines were searched for in and around houses, using an aerosol that dislodged them from their hiding places. Selective sprayings were carried out only where a colony of T. infestans was found. During the 30 months of follow-up, the percentage of houses in which any T. infestans were captured varied between 3% and 9%. In six houses, T. infestans were captured during more than one evaluation. The number of peridomiciliary areas found to be infested (19) was double the number of infested houses (9). Colonies of T. infestans were found only in the peridomiciliary areas, where the number of T. infestans captured was six times higher than in the houses. Chickens were the host most frequently associated with peridomiciliary foci. This area was the origin and principal source of reinfestation. To reduce the speed of reinfestation and the frequency with which sprayings are needed, the following environmental and chemical control methods must be combined in the peridomiciliary area: reduce the number of hiding places of triatomines; restrict the raising of birds to structures that cannot be colonized by triatomines; apply an insecticide that is less likely to be degraded by exposure to the elements, or perform a second spraying 6 to 12 months after the first; and employ a device for early detection of the presence of T. infestans around houses.

Aerosols↗

Genetic variability and geographic differentiation among three species of Triatomine bugs (Hemiptera-Reduviidae).

Three species of triatomine bugs, Triatoma sordida, T. guasayana, and T. patagonica, were examined by cytogenetic (C-banded karyotypes and male meiotic process) and isoenzymatic studies. These three species, with different importance as Chagas' disease vectors, were found to be closely related according to their known ethologic, ecologic, and morphologic traits. Although they have the same diploid chromosome number (2n = 22 constituted by 20 autosomes and an XY male/XX female sex mechanism), each species has a distinct chromosomal behavior during male meiosis and a specific amount and localization of C-heterochromatic blocks. Moreover, these chromosome characteristics allowed us to differentiate two T. sordida populations. Isoenzymatic data confirmed the taxonomic status of the three species and together with our cytogenetic results questioned the species homogeneity of T. sordida.

Animals↗

Long-term intracavernous self-injection with prostaglandin E1 for the treatment of erectile dysfunction.

Intracavernous self-injection with vasoactive drugs has become a widely accepted treatment for erectile dysfunctions (ED). Sixty-eight patients affected by ED have been followed during long-term (at least 1 year) treatment with intracavernous prostaglandin E1. Each patient underwent a penile dynamic ultrasound examination using a high-definition probe (13 MHz) before and during the treatment. The drop-out rate was 8.8%. An improvement in spontaneous erections was reported by 13% of patients. The onset of fibrotic nodules occurred in three (4.4%) patients. In one of the latter cases the occurrence of nodules could be related to the frequency and dose of the drug administered, whereas in the other two cases no such correlation could be hypothesized. These findings draw attention to this possible side-effect of long-term treatment with PGE1.

Adult↗

Probability of infection with Trypanosoma cruzi of the vector Triatoma infestans fed on infected humans and dogs in northwest Argentina.

The probability that an uninfected Triatoma infestans would become infected with Trypanosoma cruzi after a single feed on people or dogs seropositive for T. cruzi was estimated in Amama, a rural village in northwest Argentina where transmission had resurged four years earlier. The prevalence of seropositivity for T. cruzi was 34.2% among 225 people tested, and 65.1% among 83 dogs tested. Parasitemia was detected by xenodiagnosis in 29.3% of 41 seropositive persons and in 85.3% of 34 seropositive dogs. Parasitemia decreased with age more sharply in seropositive people than in seropositive dogs. Seropositive humans infected 2.6% (95% confidence interval = 1.6%-3.6%) of 963 third or fourth instar nymphs fed once on them, whereas dogs infected 48.7% (44.7%-52.7%) of 610 nymphs. The probability of bug infection increased significantly with instar and was positively related to molting success. The infectivity to bugs of seropositive dogs was 12 times higher than that of seropositive children, and 100 times higher than that of seropositive adults. The weighted probability of infection of an uninfected bug fed randomly on any dog (0.3082) was about 50 times higher than that of bugs fed on any human (0.0062). Such differences in relative infectivity, combined with the relative host-feeding preference of domiciliary Triatoma infestans for dogs, reinforces the important role of domestic dogs as a risk factor for the domestic transmission of T. cruzi.

Adolescent↗

Laboratory comparison of feeding success among Triatoma infestans, T. guasayana, and T. sordida (Hemiptera: Reduviidae).

Success in obtaining a blood meal and rapid access to hiding places after feeding are the principal requirements triatomines have as they colonize artificial ecotopes. Feeding success and postfeeding location of 3rd and 5th instars of Triatoma sordida (Stål), of T. guasayana Wygodzinsky & Abalos, and T. infestans (Klug) were studied in an experimental box in which triatomines and a chicken were left to interact overnight. The bird was enclosed in a glass cube, slightly raised to allow triatomines to get in and out, turning the space outside into an extensive refuge area. Four bunches of dry corn husks and a wooden panel were also offered as shelters. The number of live and dead insects and their locations at the end of the experiment were recorded. Predation--as the percentage of missing insects--and success--as the percentage of insects alive and fed--were calculated. Interactions with the host were different among species and sometimes also between individuals of different life stages of the same species. Predation was always > 20%. T. sordida was the best exploiter of the blood source, because 3rd instars were more successful and 5th instars were as successful as the corresponding T. infestans stages. Performance of T. guasayana was equivocal because survival and feeding success were different for both instars. T. infestans showed a pronounced tendency to climb, and 3rd instars of T. guasayana were equally distributed in the upper half of the box and in the corn husks, whereas the majority of T. sordida and 5th instars of T. guasayana sheltered in the husks.

Animals↗

Inter and intra-individual variability of sperm morphology after selection with three different techniques: layering, swimup from pellet and percoll.

Sperm morphology has been suggested to be one of the most reliable factor in predicting male fertility potential both in spontaneous cycles and in assisted reproduction. In this work the morphology of spermatozoa selected with three different techniques (layering, swimup from pellet and mini-percoll) has been assessed and compared in 20 infertile patients. All the techniques allowed the recovery of sperm populations of a better quality than in basal samples, with a higher percentage of normal forms (p < 0.001). No significant differences were observed among the three different techniques in selecting sperm populations. The scatter diagrams comparing pairwise differences between the methods against their means regard the percentage of normal forms selected show a great (over 20%) inter and intra-individual variability. These data demonstrate that the three techniques select different percentages of normal spermatozoa, even in the same patient. Since it is crucial to obtain the highest number of morphologically normal and motile spermatozoa and each technique may provide different results in a given patient, we suggest that at least two techniques of sperm selection be performed before assisted reproduction procedures. This combined testing could also be relevant in the prognostic evaluation of the infertile male, since it explores the different characteristics of sperm function.

Adult↗

Treatment of abacterial prostato-vesiculitis with nimesulide.

The efficacy and tolerability of nimesulide were assessed in the treatment of patients with prostato-vesiculitis. In a noncomparative investigation, 30 patients received oral nimesulide 100mg twice daily for three 10-day cycles. Micturition-related symptoms were resolved in 20 patients and clear amelioration of inflammatory signs was observed with transrectal ultrasound in 16 patients. Abnormal sperm forms decreased from 57 to 49% (p < 0.001). In a comparative investigation, 40 patients received nimesulide 200mg twice daily or ketoprofen 100mg twice daily via the rectal route. Patients and physicians expressed an overall opinion on efficacy in favour of nimesulide. In a pharmacokinetic study of healthy volunteers who received oral nimesulide 100mg as a single dose, the mean maximum nimesulide concentration (0.58 +/- 0.13 mg/L) in seminal fluid was achieved after 2 hours while the maximum seminal fluid: blood plasma ratio 0.32 +/- 0.02 was observed after 4 hours. These data suggest that nimesulide is an effective NSAID in the treatment of abacterial prostato-vesiculitis and also demonstrate that this drug has a favourable disposition within the genital tract.

Adolescent↗

[Recent diagnostic and therapeutic aspects in male sexual impotence].

Male sexual impotence is the symptom of an alteration of central and peripheral mechanism neuropsychoendocrine, vascular and neurological. Nowadays it affects 8-10% of sexually active population. In some diseases, like diabetes and uremia, it can reach very high percentages of incidence. At our Andrology Center 35% of referrals are represented by sexual complaints. In the last years the diagnostic accuracy has increased, narrowing the percentage of unknown causes. Vasculopathy represents the most relevant pathological condition associated with impotence: it can affect both arterial and venous vessels. The new medical technologies and procedures permit an increase of the life span but often affecting the quality of life. Therefore, the iatrogenic causes of impotence, both pharmacological and surgical, are growing. A modern diagnostic approach starts with an accurate clinical history and physical examination, followed by an NPT (nocturnal penile tumescence) test and/or ICI (intracavernosal injection) with a standard dose of PGE1 and Doppler flowmetry of penile arteries. An endocrine evaluation (LH, testosterone and prolactin) is also performed. Further investigation of a vascular dysfunction is represented by more invasive procedures, like arteriography, cavernosography and cavernosometry. A suspect of neurological disease is confirmed by sacral evoked potentials. According to the findings of these examinations, a correct therapeutical approach can be applied in 100% of cases. An endocrine treatment is adequate only when a clear reduction of T plasma level or hyperprolactinemia are present. The treatment of other central disorders causing psychoneuroendocrine impotence is promising, but still under investigation. The intracavernosal injection of vasoactive drugs, apart from having revolutionized the diagnostic approach to the impotent patient, represents a clear standpoint in medical management of impotence, particularly in vascular and neurological diseases. The great advancement in the technology of penile prostheses has allowed the development of valuable and reliable tools to be used in selected cases.

Adult↗

[The Rigiscan system in the diagnosis of male sexual impotence].

The article reviews historical basis of Nocturnal Penile Tumescence (NPT) test and the evolution of techniques to perform it. From complex and time-consuming instruments, modern technology has brought us to the use of the Rigiscan system. This is a transportable (home or office usable), computerized method to detect change of penile rigidity and circumference during sleep-related spontaneous-or daytime induced-erections. While the instrument was mainly developed to perform NPT tests, it is nowadays used to record penile rigidity in realtime after the intracavernous injection of vasoactive drugs. In our experience, normal parameters to refer for a NPT evaluation are: number of erectile episodes: 4-5 per night; mean duration od episodes: > 30 minutes; increase of penile circumference: > 3 cm (base loop) and > 2 cm (tip loop); maximal rigidity: > 70% (both base and tip). Reference parameters for realtime monitoring after intracavernous injection of PGEI are: latency of response: < 12 minutes; duration (with a stable plateau): > 30 minutes; constant plateau: > 70%; increase of penile circumference: > 3 cm (base) and > 2 cm (tip). The use of these reference parameters, together with the data coming from other procedures (e.g. penile arterial flow with the Doppler), allows a better diagnostic accuracy in the approach to sexual impotence.

Diagnosis, Computer-Assisted↗

[Endocrine therapy of sexual impotence in men].

Male sexual activity is in all mammalian species, included man, androgen-dependent. The role of testosterone (T) starts already during intrauterine life. It continues thereafter, inducing the development of sexual secondary characteristics and libido. Therefore T has represented the "classical" treatment of male sexual dysfunctions. In the therapeutic routinary use T is employed ad ester, like cipionate, enanthate and other i.m., undecanoate per os. When a pituitary defect is present and the testicular receptors are functioning a treatment with HCG can be employed.

Chorionic Gonadotropin↗