Baseline Levels In Group Research Articles

Evaluating utility of routine ferritin testing in blood donors: A hospital‐based blood donor centre experience

Background and ObjectivesIron deficiency (ID) poses a prevalent concern among blood donors, especially impacting young donors, premenopausal females and frequent donors. In alignment with recommendations to address ID, routine ferritin testing was implemented in a hospital‐based donor centre.Materials and MethodsData set, encompassing 26 164 ferritin values from 16 464 blood donors over 33 months, were analysed retrospectively. Ferritin levels were assessed concerning donor characteristics such as sex, age, ethnicity and donation frequency.ResultsFerritin testing revealed age, sex and ethnicity variations, emphasising the heightened risk of ID in young females meeting all donation criteria under 23 year of age who demonstrated the lowest mean baseline ferritin (41% [CI: 34%–48%] < 26 ng/mL; 20% [CI: 14%–25%] < 15 ng/mL). Postmenopausal females exhibited ferritin levels similar to similarly aged males. Irrespective of sex, donors showcased mean ferritin recovery within 6 months. Analysis of ferritin recovery post‐donation showed a five‐fold increase in risk (compared with first visit) of ID when donors return at a 2‐month interval. ‘Regular’ donors (≥10 visits) approach a median steady ferritin level (~30–35 ng/mL) by the sixth visit.ConclusionAs reliance on regular blood donors increases, donation policies must strike a balance between blood centre resources and the risks posed to both regular and at‐risk donors. Frequent blood donation led to donors attaining a mean steady state ferritin level above the threshold for ID. At‐risk groups, particularly premenopausal females, were several times more likely to experience ID after donation but demonstrated recovery rates similar to their group's baseline levels. This valuable information informed the development of new donor deferral policies.

The Importance of the Trigeminal Cardiac Reflex in Rhinoplasty Surgery

Trigeminocardiac reflex (TCR) consists of bradycardia or asystole along with hypotension and apnea coinciding with stimulation of the trigeminal nerve. During rhinoplasty procedures, we noticed that local anesthetic solution (LAS) application to the columellar area results in bradycardia. We planned to conduct a randomized prospective study on 47 patients undergoing rhinoplasty to demonstrate the characteristics of TCR arising from the columella. Local anesthetic solution containing 2% prilocaine with 1:80,000 adrenaline was applied under standard general anesthesia protocol. In group 1 (study group, n = 24), 2 mL of LAS was applied to the columella. In group 2 (control group, n = 23), 2 mL of LAS was applied to the nasal dorsum. In group 3 (control group, n = 20), after LAS was applied to nasal dorsum in group 2, we waited for 10 minutes. Then, 2 mL of LAS was applied to the columella. Here, recordings were taken for the columella.Heart rate (HR) and blood pressure (BP) were recorded just before needle insertion (baseline level), at the time of needle insertion (NIT) to the columella or dorsum, and after the 1st, 5th, 10th, 30th, and 60th seconds. Transient bradycardia (≥20% drop in HR) was observed in 33% of the patients in group 1.Decrease in HR compared to the baseline level in group 1 was significantly greater than that of groups 2 and 3 at all times (P ≤ 0.05).Systolic BP in NIT and in 60th second in group 1, only in NIT in group 2 was significantly lower than that of baseline levels (P ≤ 0.05). We concluded that stimulation of a sensory branch of the trigeminal nerve in the columellar area leads to TCR under general anesthesia by eliciting clinical hypotension with a drop in systolic BP and in HR of more than 20% compared to the baseline level.Knowing the existence of a certain TCR area will be helpful to the surgeon and anesthesiologist to exercise extra vigilance and to make continuous and meticulous monitoring of the electrocardiogram, HR, and BP during which the TCR may be precipitated such as local anesthetic infiltration to the columellar area in rhinoseptoplasty operations.

Moderate Amounts of Vitamin D3 in Supplements are Effective in Raising Serum 25-Hydroxyvitamin D from Low Baseline Levels in Adults: A Systematic Review

There is controversy surrounding the designation of vitamin D adequacy as defined by circulating levels of the metabolite 25-hydroxyvitamin D (25(OH)D). Depending on the cutoff level chosen, dietary intakes of vitamin D may or may not provide sufficient impact upon vitamin D status measured as improvement in serum levels of 25(OH)D. We sought to examine whether modest daily doses (5–20 μg) as found in fortified foods or multivitamin supplements had a measureable impact on vitamin D status, defined as moving from below to above 50 nmol/L, or from less than 30 nmol/L to above 30 nmol/L. Published literature was searched for relevant articles describing randomized controlled trials. Exclusion criteria were: studies not involving humans; review articles; studies lacking blood level data pre- and post-treatment; no control group; bolus treatments (weekly, monthly, yearly); vitamin D <5 μg or >20 μg; baseline 25(OH)D ≥75 nmol/L; subjects not defined as healthy; studies <8 weeks; and age <19 years. Of the 127 studies retrieved, 18 publications with 25 separate comparisons met criteria. The mean rate constant, defined as change in 25(OH)D in nmol/L per μg vitamin D administered, was calculated as 2.19 ± 0.97 nmol/L per μg. There was a significant negative correlation (r = −0.65, p = 0.0004) between rate constant and administered dose. To determine impact of the dose reflecting the Estimated Average Requirement (EAR) of 10 μg administered in nine studies (10 comparisons), in every case mean 25(OH)D status rose either from “insufficient” (30–50 nmol/L) to “sufficient” (>50 nmol/L) or from “deficient” (<30 nmol/L) to “insufficient” (>30 but <50 nmol/L). Our study shows that when baseline levels of groups were <75 nmol/L, for every microgram of vitamin D provided, 25(OH)D levels can be raised by 2 nmol/L; and further, when groups were deficient or insufficient in vitamin D, there was significant value in providing additional 10 μg per day of vitamin D.

Cytokeratin-19 fragments, nucleosomes and neuron-specific enolase as early measures of chemotherapy response in non-small cell lung cancer

To investigate the reduction in the serum level of cytokeratin-19 fragments (CYFRA 21-1), nucleosomes and neuron-specific enolase (NSE) as early measures of the response to chemotherapy in non-small cell lung cancer (NSCLC). Forty-two consecutive patients with locally advanced NSCLC were included. All patients received platinum-based chemotherapy. Staging investigations and quantification of CYFRA 21-1, nucleosomes and NSE (using enzyme-linked immunosorbent assay, ELISA) were performed before the start of treatment and after the second cycle of chemotherapy. According to the response to chemotherapy, patients were classified into 3 groups: (I) disease regression, (II) stable disease, and (III) progressive disease. The reduction in the levels of tumor markers was correlated with the response to chemotherapy. After the second cycle of chemotherapy, groups I and II had significantly decreased serum levels of CYFRA 21-1 (p<0.05). Similarly, the concentration of nucleosomes was significantly lower than the baseline levels in groups I (p=0.0008) and II (p=0.003). The reduction of both CYFRA 21-1 and nucleosome levels was not significant for patients in group III. In all groups the reduction of NSE levels in response to chemotherapy was not significant. As a marker of response to chemotherapy, CYFRA 21-1 showed the highest sensitivity (88.9%) and specificity (77.4%) compared with nucleosomes (77.8% and 58.1% respectively) and NSE (66.7% and 51.8% respectively). The reduction in the serum level of CYFRA 21-1 and nucleosomes may be used for early identification of NSCLC patients with good response to chemotherapy.

Does Nebivolol Prevent Contrast‐Induced Nephropathy in Humans?

An experimental study showed that nebivolol is an effective agent in contrast-induced nephropathy (CIN) prophylaxis. We hypothesized that prophylactic nebivolol use had protective effects on renal function in human beings subjected to iodinated contrast agent since it has vasodilatory effect and antioxidant properties. The present study enrolled 120 patients scheduled for coronary angiography and ventriculography. All patients were hydrated with intravenous isotonic saline. The patients in group I received 600 mg N-acetylcysteine every 12 hours for 4 days. The patients in group II received 5 mg nebivolol every 24 hours for 4 days. The patients in group III were only hydrated. The primary endpoint was the occurrence of CIN. The secondary endpoint was the change in serum creatinine (Cr) levels at 2 days and 5 days after the contrast exposure. Nine (22.5%) patients in group I developed CIN, as did 8 patients (20.0%) in group II and 11 patients (27.5%) in group III (P = 0.72). Changes in mean Cr level from baseline to day 2 were not statistically significant in all groups. However, we detected a statistically significant increase in mean Cr levels at day 5 compared with baseline levels in group I and group III (from 1.42 ± 0.13 to 1.52 ± 0.26, p2 = 0.02; and from 1.43 ± 0.14 to 1.55 ± 0.30, p2 = 0.01, respectively). Although an increase was detected in mean Cr level from baseline to the 5-day Cr level in group II, this did not reach statistical significance (from 1.40 ± 0.12 to 1.48 ± 0.23, P = 0.06). Pretreatment with nebivolol is protective against nephrotoxic effects of contrast media.

Optimal brain temperature for retrograde cerebral perfusion in dogs

We investigated the optimal brain temperature during the period of retrograde cerebral perfusion (RCP). Eighteen mongrel dogs were divided into three groups according to brain temperatures during the period of RCP: L (15°C), M (20°C), and H (25°C). Following hypothermia using cardiopulmonary bypass (CPB), RCP was performed for 60 minutes via the bilateral internal maxillary veins with a perfusion pressure of 25 mmHg. The animals were then rewarmed for 60 minutes. Cerebral blood flow (CBF) was measured by laser Doppler flowmetry. The cerebral metabolic rate for oxygen (CMRO2) and glucose (CMRGlu), excretion of carbon dioxide (ExCO2), and lactate/pyruvate (L/P) ratio were calculated. During the period of RCP, brain temperature significantly (p<0.05) increased in Group L. CBF, CMRO2, ExCO2, and CMRGlu significantly (p<0.05) decreased to less than 20% of the baseline levels during the period of RCP in all groups. After RCP, CBF recovered noticeably beyond the baseline levels in Group M (130%). CMRO2 and ExCO2 levels in Groups M and H tended to be higher than those in Group L during the rewarming phase. Increase of CMRGlu immediately after RCP was higher in Group M compared with other groups. The L/P ratio in Group M was lower than that in the other two groups during RCP. In conclusion, the brain temperature in the range 20°C may be suitable for maintaining optimal cerebral metabolic activity for RCP.

Elevated Serum ALT Levels during Pegylated Interferon Monotherapy May Be Caused by Hepatic Iron Overload

Objective: Persistently elevated serum alanine aminotransferase (ALT) levels have been observed in chronic hepatitis C (CHC) patients during pegylated interferon (PEG-IFN) therapy. We investigated whether elevated serum ALT levels during PEG-IFN therapy are associated with iron overload. Methods: Sixty-three CHC patients treated with PEG-IFNα-2a monotherapy were evaluated. The associations between elevated serum ALT levels (≧70 IU/l) were investigated before and 24 weeks after therapy. We classified patients as follows: patients with no elevated serum ALT levels (group NE: n = 35), patients with elevated serum ALT levels (group E: n = 28), and patients with no elevated serum ALT level and negative HCV RNA (group NE–: n = 24), and patients with elevated serum ALT level and negative HCV RNA (group E–: n = 19). We also compared total iron score (TIS) and fibrosis stage in liver specimens obtained before and during therapy from 3 patients with elevated serum ALT levels. Results: Serum ferritin levels were significantly increased after 24 weeks compared to baseline levels in group E (218 ± 273 vs. 438 ± 308 ng/ml; p < 0.0001) and group E– (146 ± 152 vs. 410 ± 291 ng/ml; p < 0.0001). Serum ALT and ferritin levels were significantly correlated after 24 weeks. The liver specimens revealed that TIS and fibrosis progressed during therapy. Conclusion: Our findings suggest that the elevation in serum ALT levels during therapy is caused by iron overload which may be induced by PEG-IFNα-2a.

Oral antihistamine therapy influences plasma tryptase levels in adult atopic dermatitis

Oral antihistamine therapy influences plasma tryptase levels in adult atopic dermatitis

Effect of Erythropoietin on Urinary Liver-Type Fatty-Acid-Binding Protein in Patients with Chronic Renal Failure and Anemia

Background/Aim: The urinary liver-type fatty-acid-binding protein (L-FABP) level reflects the clinical progression of chronic kidney disease. We conducted a study to determine whether administration of erythropoietin (EPO), which is produced in response to hypoxic stress, affects urinary protein excretion and L-FABP levels in patients with chronic renal failure (CRF) and anemia. Methods: The study was an interventional trial that included 20 anemic CRF patients (median serum creatinine level 2.0 mg/dl, range 1.3–2.9 mg/dl; median hemoglobin concentration 9.2 g/dl, range 8.2–9.8 g/dl; median estimated glomerular filtration rate 20.5 ml/min, range 15.0–28.0 ml/min; group A). Recombinant EPO (12,000 U twice/month) was given to these patients for 6 months. Urinary protein, L-FABP, 8-hydroxy-2′-deoxyguanosine, and hemoglobin levels were measured before and 3 and 6 months after treatment. Twenty nonanemic CRF patients were enrolled as controls (group B). Results: After 6 months, the hemoglobin level was increased as compared with the baseline level in group A treated with EPO (median 11.3 g/dl, range 9.3–13.8 g/dl, vs. median 9.2 g/dl, range 8.2–9.8 g/dl; p < 0.01) but not in the untreated group B (median 11.8 g/dl, range 10.2–13.0 g/dl, vs. median 12.1 g/dl, range 10.8–13.4 g/dl; not significant). The urinary protein excretion was decreased as compared with the baseline level in group A (median 1.2 g/day, range 0.6–1.9 g/day, vs. median 1.9 g/day, range 1.1–2.6 g/day; p < 0.01) but not in group B (median 1.4 g/day, range 0.7–2.2 g/day, vs. median 1.6 g/day, range 0.7–2.3 g/day; not significant). The urinary L-FABP level was also decreased as compared with the baseline level in group A (median 50.0 µg/g creatinine, range 7.5–90.0 µg/g creatinine, vs. median 115.0 µg/g creatinine, range 20.0–225.0 µg/g creatinine; p < 0.01) but not in group B (median 82.0 µg/g creatinine, range 15.5–158.0 µg/g creatinine, vs. median 76.0 µg/g creatinine, range 25.0–138.5 µg/g creatinine; not significant). The glomerular filtration rate changed little throughout the study period in either group. The urinary 8-hydroxy-2′-deoxyguanosine level was decreased as compared with the baseline level in group A (median 22.0 ng/mg creatinine, range 8.0–30.0 ng/mg creatinine, vs. median 38.5 ng/mg creatinine, range 14.0–68.0 ng/mg creatinine; p < 0.01) but not in group B (median 33.0 ng/mg creatinine, range 9.0–56.0 ng/mg creatinine, vs. median 30.0 ng/mg creatinine, range 10.0–54.0 ng/mg creatinine; not significant). Conclusion: EPO supplementation may ameliorate renal tubular damage, in part, due to a reduction of oxidative stress in CRF patients with anemia.

Effect of Atorvastatin on the Recurrence Rates of Atrial Fibrillation After Electrical Cardioversion

Effect of Atorvastatin on the Recurrence Rates of Atrial Fibrillation After Electrical Cardioversion

Metabolic response to short-term 4-day energy restriction in a controlled study

Metabolic rate is affected not solely by diet but also by environmental characteristics such as climate and seasonal changes in day length. In the present study, we conducted a controlled study in which we observed metabolic response to short-term energy restriction (ER). Thirty-two subjects were divided randomly into a slight ER group and a moderate ER group. The energy intake per day for slight ER vs moderate ER was 1462 kcal vs 1114 kcal. During the 4-day study periods, the same daily timetable, which consists of nutrition, exercise, sleeping and others, was imposed on both groups. The same environment was also provided to both groups. After the 4-day ER, significant decreases in body weight and basal metabolic rate (BMR) were shown in both groups. The decrease in body weight was 2% of the baseline level in both groups, and the decreases in the BMR were 6% of baseline levels in the slight ER group and 13% in the moderate ER group. The decrease in BMR in the moderate ER group was significantly larger than that in the slight ER group. In a controlled study of short-term ER, we observed a significant decrease in BMR. There was a positive association between the degree of ER and the reduction in BMR. Reductions in BMR were greater than those in body weight. It, thus, appears that the minimization of weight loss is due to dramatic decreases in BMR. This suggests the existence of metabolic resistance against ER.

Presence of factors that activate platelet aggregation in mitral stenotic patients' plasma

BackgroundAlthough the association between mitral stenosis (MS) and increased coagulation activity is well recognized, it is unclear whether enhanced coagulation remains localized in the left atrium or whether this represents a systemic problem. To assess systemic coagulation parameters and changes in platelet aggregation, we measured fibrinogen levels and performed in vitro platelet function tests in plasma obtained from mitral stenotic patients' and from healthy control subjects' peripheral venous blood.MethodsSixteen newly diagnosed patients with rheumatic MS (Group P) and 16 healthy subjects (Group N) were enrolled in the study. Platelet-equalized plasma samples were evaluated to determine in vitro platelet function, using adenosine diphosphate (ADP), collagen and epinephrine in an automated aggregometer. In vitro platelet function tests in group N were performed twice, with and without plasma obtained from group P.ResultsThere were no significant differences between the groups with respect to demographic variables. Peripheral venous fibrinogen levels in Group P were not significantly different from those in Group N. Adenosine diphosphate, epinephrine and collagen-induced platelet aggregation ratios were significantly higher in Group P than in Group N. When plasma obtained from Group P was added to Group N subjects' platelets, ADP and collagen-induced, but not epinephrine-induced, aggregation ratios were significantly increased compared to baseline levels in Group N.ConclusionPlatelet aggregation is increased in patients with MS, while fibrinogen levels remain similar to controls. We conclude that mitral stenotic patients exhibit increased systemic coagulation activity and that plasma extracted from these patients may contain some transferable factors that activate platelet aggregation.

In vivo inhibition of neutrophil activity by a FAS (CD95) stimulating module: arterial in-line application in a porcine cardiac surgery model

In vivo inhibition of neutrophil activity by a FAS (CD95) stimulating module: arterial in-line application in a porcine cardiac surgery model

Coronary active perfusion system can maintain myocardial blood flow and tissue oxygenation.

To avoid myocardial ischemia in off-pump coronary artery bypass, we developed a coronary active perfusion system (CAPS). The purposes of this study were to investigate the changes in myocardial blood flow and tissue oxygenation during CAPS perfusion, and to validate the ventricular arrhythmias and hemodynamic deterioration preventing the effect. Sixteen pigs were divided into a CAPS perfusion group (group C) and a simple coronary occlusion group (group O). The left anterior descending coronary artery was snared in both groups and 30 min of CAPS perfusion was performed in group C. Ventricular arrhythmias were not observed in group C, but occurred in seven out of eight pigs in group O (P=0.003). None of the hemodynamic variables changed in group C, but they deteriorated in group O. Myocardial blood flow, saturation, and hemoglobin plus myoglobin concentration were maintained with a baseline level in group C, but decreased significantly in group O (P<0.001). CAPS is a reliable method to avoid myocardial ischemia during coronary occlusion and it may be useful for off-pump coronary artery bypass

The Effect of Low Dose Nitroglycerin on Hemodynamics and Local Liver Perfusion Following an Occlusion and Reperfusion of the Hepatic Artery and Portal Vein in Experimental Dogs

Background: To reduce massive blood loss during a hepatectomy, many anesthesiologists have used the technique of low central venous pressure maintenance by administration of low dose nitroglycerin (NTG) and/or intravenous fluid reduction. However, so far there have been no studies about local liver perfusion (LLP) changes after hepatic artery (HA) or portal vein (PV) reperfusion in patients receiving nitroglycerin administration. In this study, the changes in hemodynamics and LLP following HA and PV reperfusion along with low dose (2/kg/min) NTG administration in dogs were observed. Methods: A total of 20 mongrel dogs were divided into four groups; HA occlusion and reperfusion group (H, n = 5), NTG administration group during the reperfusion on H (H-NTG, n = 5), PV occlusion and reperfusion group (P, n = 5), NTG administration group during the reperfusion on P (P-NTG, n = 5). After femoral and pulmonary arterial catheterization, a midline abdominal incision was made. HA and PV were exposed to clamp and declamp. A thermal diffusion microprobe was inserted in the liver parenchyme to measure LLP. Results: The PV blood flow was not changed after HA occlusion, but HA blood flow increased after PV occlusion. The LLP decreased after HA and PV occlusion. The LLP recovered to the baseline level in group H-NTG after HA reperfusion, but the LLP was more increased compared to the baseline level in group H. In group P, the LLP did not recover after PV reperfusion, but the LLP in group P-NTG recovered to the baseline level after PV reperfusion. Conclusions: In conclusion, it was observed that the LLP recovered to the baseline level by administration of NTG after PV reperfusion. However, the LLP did not increase after HA reperfusion by administration of low dose NTG.

Optimal brain temperature for retrograde cerebral perfusion in dogs

We investigated the optimal brain temperature during the period of retrograde cerebral perfusion (RCP). Eighteen mongrel dogs were divided into three groups according to brain temperatures during the period of RCP: L (15°C), M (20°C), and H (25°C). Following hypothermia using cardiopulmonary bypass (CPB), RCP was performed for 60 minutes via the bilateral internal maxillary veins with a perfusion pressure of 25 mmHg. The animals were then rewarmed for 60 minutes. Cerebral blood flow (CBF) was measured by laser Doppler flowmetry. The cerebral metabolic rate for oxygen (CMRO2) and glucose (CMRGlu), excretion of carbon dioxide (ExCO2), and lactate/pyruvate (L/P) ratio were calculated. During the period of RCP, brain temperature significantly (p < 0.05) increased in Group L. CBF, CMRO2, ExCO2, and CMRGlu significantly (p < 0.05) decreased to less than 20% of the baseline levels during the period of RCP in all groups. After RCP, CBF recovered noticeably beyond the baseline levels in Group M (130%). CMRO2 and ExCO2 levels in Groups M and H tended to be higher than those in Group L during the rewarming phase. Increase of CMRGlu immediately after RCP was higher in Group M compared with other groups. The L/P ratio in Group M was lower than that in the other two groups during RCP. In conclusion, the brain temperature in the range 20°C may be suitable for maintaining optimal cerebral metabolic activity for RCP.

Optimal Brain Temperature for Retrograde Cerebral Perfusion in Dogs

We investigated the optimal brain temperature during the period of retrograde cerebral perfusion (RCP). Eighteen mongrel dogs were divided into three groups according to brain temperatures during the period of RCP: L (15°C), M (20°C), and H (25°C). Following hypothermia using cardiopulmonary bypass (CPB), RCP was performed for 60 minutes via the bilateral internal maxillary veins with a perfusion pressure of 25 mmHg. The animals were then rewarmed for 60 minutes. Cerebral blood flow (CBF) was measured by laser Doppler flowmetry. The cerebral metabolic rate for oxygen (CMRO2) and glucose (CMRGlu), excretion of carbon dioxide (ExCO2), and lactate/pyruvate (L/P) ratio were calculated. During the period of RCP, brain temperature significantly (p < 0.05) increased in Group L. CBF, CMRO2, ExCO2, and CMRGlu significantly (p < 0.05) decreased to less than 20% of the baseline levels during the period of RCP in all groups. After RCP, CBF recovered noticeably beyond the baseline levels in Group M (130%). CMRO2 and ExCO2 levels in Groups M and H tended to be higher than those in Group L during the rewarming phase. Increase of CMRGlu immediately after RCP was higher in Group M compared with other groups. The L/P ratio in Group M was lower than that in the other two groups during RCP. In conclusion, the brain temperature in the range 20°C may be suitable for maintaining optimal cerebral metabolic activity for RCP.

Can testosterone alone maintain the gonadotrophin-releasing hormone antagonist-induced suppression of spermatogenesis in the non-human primate?

The combination of gonadotrophin-releasing hormone (GnRH) antagonist and delayed testosterone substitution provides a promising approach towards male contraception. However, the GnRH antagonists used clinically so far cause side-effects and have to be administered continuously. We therefore used the non-human primate model to see whether the GnRH antagonist cetrorelix (which exhibits a favourable benefit-to-risk ratio in terms of anti-gonadotrophic action in normal men) induces complete and reversible suppression of spermatogenesis and whether GnRH antagonist-induced suppression of spermatogenesis can be maintained by testosterone alone. Four groups of adult cynomolgus monkeys (Macaca fascicularis; five per group) were injected daily with 450 micrograms cetrorelix/kg ([N-acetyl-D-2-naphthyl-Ala1, D-4-chloro-Phe2, D-pyridyl-Ala3, D-Cit6, D-Ala10]-GnRH). Group 1 received the GnRH antagonist for 7 weeks followed by vehicle administration for another 11 weeks; group 2 was treated with GnRH antagonist for the entire 18 weeks with each animal receiving a single testosterone implant during weeks 11-18 to restore the ejaculatory response to electrostimulation; group 3 received the GnRH antagonist for 18 weeks and testosterone buciclate (TB) was injected during week 6 of GnRH antagonist treatment; group 4 was subjected to GnRH antagonist administration for 7 weeks and received TB (200 mg/animal) during week 6. Under GnRH antagonist treatment alone serum concentrations of testosterone were suppressed. TB maintained testosterone levels two- to fourfold above baseline levels in groups 3 and 4 and prevented the recovery of LH secretion for about 20 weeks after GnRH antagonist withdrawal, whereas inhibin levels increased significantly from week 8 onwards. Group 2 animals were azoospermic during weeks 12-18 of GnRH antagonist administration. The TB-replaced groups developed azoospermia or became severely oligozoospermic. Quantitation of cell numbers by flow cytometry during weeks 6 and 18 revealed that TB (groups 3 and 4) had prevented a further decline of germ cell production compared with group 2 but had maintained the spermatogenic status present at week 6 (onset of TB substitution). All inhibitory effects of cetrorelix and/or TB were reversible after cessation of treatment. These findings demonstrate that cetrorelix reversibly inhibits spermatogenesis in a non-human primate model. Although TB maintained the GnRH antagonist-induced suppression of spermatogenesis, azoospermia was not achieved. This latter effect may reflect either a direct spermatogenesis-supporting effect of the high dose of TB or the partial recovery of inhibin secretion (indirectly reflecting FSH secretion) or a combination of both.(ABSTRACT TRUNCATED AT 400 WORDS)

The protective effect of magnesium on acute catecholamine cardiotoxicity in the neonate

The protective effect of magnesium on acute catecholamine cardiotoxicity in the neonate

A Clinical Trial of a Behavioral Therapy to Reduce Urinary Incontinence in Nursing Homes

One hundred thirty-three incontinent women in seven nursing homes were assigned randomly to a 13-week behavior therapy program for urinary incontinence or to a control group that received usual incontinence-related care. The therapy became effective after 6 weeks of training. By the final month of training, the treatment women's wet episodes had been reduced by 0.6 episodes per day, a 26% reduction over baseline. This reduction in the number of wet episodes was statistically significant, both with respect to this group's baseline levels of incontinence and in comparison with the performance of the control women. The number of wet episodes in the control group remained about the same throughout training and the 22-week follow-up period. The treatment women improved partly because they learned to request help, a response prompted and reinforced by the program. Trainees with a high frequency of incontinence during baseline, the more cognitively intact residents, and residents with normal bladder capacity responded better to this behavior therapy program.