Ml In Men Research Articles

Pure Red Cell Aplasia Secondary to Parvovirus B19 Infection in HIV Positive Patients. Clinical and Seroepidemiological Description and Observations in A Third Hospital Level In Colombia

Objective: Describe the clinical and seroepidemiological characteristics and the impact on morbidity and mortality and health costs of patients infected with HIV and red cell aplasia and positive serology for Parvovirus B 19. Methodology: Descriptive and retrospective study, of the clinical and seroepidemiological characteristics of cases of aplasia of the red series without affecting hematimetric indices in HIV positive patients with positive serology to Parvovirus B19, were descripted in an hospitalization service in the period from April 2016 to April 2017. Serum samples from the 16 patients enrolled for the study were analyzed by IgG and IgM type antibodies using the enzyme immunoassay technique. Other causes of anemia, such as: iron-deficiency anemia, invasive fungal infection were ruled out. Results: A total of 16 cases were documented, 11 men (69%) and 5 women (31%) with an average age of 40.7 and 44.4 years respectively, 5 of the 16 patients (31.25%) had positive IgM levels (distributed among 3 men and 2 women) without IgG activity documented in the same sample and 4 of these 5 patients were without treatment for their HIV (80%), none of the patients received regular treatment for HIV. The average in grams per deciliter of hemoglobin and hematocrit at the time of sampling was 8.92 g / dl and 28.6 g / dl respectively, the average of CD4 cell count was 115 for the male population and 187.2 for the female population, the average viral load was 515,483 and 369,390 copies / ml for men and women respectively. No patient received adjuvant treatment directed at the pure red anemia demonstrated. Conclusion: Persistent parvovirus B19 infections in human immunodeficiency virus type 1 infected patients have been reported. The two viruses could share common target cells. The co-infection by Parvovirus B19 is associated with longer days of hospital stay, costs and complications such as nosocomial infections and need of poly transfusions.

Type 2 Diabetes and Vitamin D Status

Vitamin D (Vitamine D), classically recognized as an important player in bone and phosphocalcic metabolism, has shown, through recent studies, its involvement in the pathogenesis of insulin resistance in case of deficiency. The aim of this work is to describe the profile of vitamin D in a type 2 diabetic population and to correlate the vitamin D status with the different metabolic parameters in this population admitted in the University Hospital of Marrakech. It is a descriptive cross-sectional study of a population of type 2 diabetic patients, coming for a follow-up assessment of diabetes and having performed an evaluation of the level of 25 hydroxy vitamin D3 in blood. Demographic, clinical, evolutionary and biological data were collected. The mean of 25 (OH) vitamin D3 was 12.55 ± 8.14 ng / ml for the group, and was 13.15 ± 8.93 ng / ml for women and 11.82 ± 7.31 ng / ml for men. These patients were classified into three groups: Group 1: 25 (OH) D 30 ng / ml present in 4 patients in this population (4, 8%). Several studies have reported an association between vitamin D status and the development of type 2 diabetes. Experimental studies have suggested that vitamin D deficiency decreases insulin sensitivity, carbohydrate tolerance and β-pancreatic function. The data of this work underline the high frequency of vitamin D deficiency in the Moroccan population suffering from type 2 diabetes.

Relationship between water intake and skeletal muscle mass in elderly Koreans: A nationwide population-based study.

The purposes of this study were to evaluate the correlation between sarcopenia and water intake and investigate lack of daily water intake in the presence of sarcopenia in an elderly population. Data from 3656 participants (1582 men and 2074 women) were analyzed using the Korea National Health and Nutrition Examination Survey. Sarcopenia was defined in accordance with the criteria of the Asia Working Group for Sarcopenia. Water intake was assessed using the dietary water adequacy ratio and was calculated by dividing the daily water intake from fluid by the recommended daily amount of 1000 mL in men and 900 mL in women. Water intake from food (g/d and cup/d) and dietary water adequacy ratio (mL) were significantly lower in the sarcopenia group (757.8 g, 890.1 g, and 0.74 mL in men; 511.9 g, 757.8 g, and 0.70 mL in women, respectively) than in the non-sarcopenia group (878.4 g, 1015.1 g, and 0.81 mL in men; 581.3 g, 790.5 g, 0.74 mL in women, respectively). In elderly men, the odds ratio of sarcopenia in the lowest quartile increased to 1.47 (range, 1.13-1.91) in Model 2 compared with that in the highest quartile. In elderly women, the odds ratio of sarcopenia in the lowest quartile increased to 1.50 (range, 1.08-2.08) in Model 2 compared with that in the highest quartile. The prevalence of sarcopenia in the elderly population was related to inadequate dietary water intake after adjusting for covariates. Adequate water intake in the elderly should be recommended to prevent dehydration-related complications, including sarcopenia.

Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults

ObjectiveCardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults. MethodsThis single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM). The higher limits of normal cut-offs were determined for these parameters and their dependency on age, gender and anthropometry were analyzed. ResultsThe body surface area (BSA) corrected higher limit cut-offs were: 59.37ml/m2 for LV end diastolic volume (59.19ml/m2 and 59.61ml/m2 for men and women, respectively; P=NS); 23.48ml/m2 for LV end systolic volume (23.27ml/m2 and 23.11ml/m2 for men and women, P=NS). Mean LVEF was 64.79%±7.26 (62.99%±6.51 and 67.05%±7.58 in men and women, P=NS). Men had higher LVM than women (119.79g±23.95 vs. 103.26g±23.76, P<0.001), this difference disappeared after BSA indexing. The higher limit cut-offs for normal LA volumes were 20.49ml for minimum volume (21.18ml and 19.46ml for men and women, P=NS) and 39.76ml for maximum volume (39.60ml and 40.03ml in men and women, P=NS). The parameters were smaller compared to western populations but the differences attenuated after BSA indexing. ConclusionsThe study reports normal 3DE parameters of size and function of left heart chambers in Indians.

Whole Red Grape Juice Reduces Blood Pressure at Rest and Increases Post-exercise Hypotension

ABSTRACTObjective: The objective of this study was to evaluate the effect of whole red grape juice (juice) on blood pressure (BP) at rest and on the magnitude of post-exercise hypotension (PEH).Methods: This double-blind, randomized controlled study was performed with 26 individuals with hypertension (40 to 59 years old) who were divided into experimental (n = 14) and control (n = 12) groups. Subsequently, the experimental group was subdivided according to the initial BP values. The subjects performed 2 sessions of aerobic exercise on a treadmill (60 minutes, 60%–85% maximum heart rate), separated by a 28-day period of supplementation with a daily dose of juice (150 ml for men and 100 ml for women) or a control drink. BP was measured before, during, and immediately after each exercise session as well as every 10 minutes during the 60-minute post-exercise recovery period.Results: The BP at rest did not change in the experimental group, but when this group was subdivided by initial BP, the subjects with controlled initial BP (EGCP) achieved a significant reduction (133.3 ± 5.6 to 114.6 ± 12.2 mmHg, p = 0.02); in contrast, the experimental group with borderline hypertensive BP values (EGBP) did not. Intervention with juice did not modify PEH in the experimental group, but when this group was divided as a function of the initial BP, PEH was potentiated at some times in EGCP.Conclusions: We conclude that juice promotes a reduction in BP at rest and is also capable of improving PEH in individuals with hypertension, but these effects are dependent on the initial BP values.

Hydration Status: Influence of Exercise and Diet Quality.

Physical activity, adherence to a healthy diet, and healthy beverage pattern are considered essential components of a healthy lifestyle. We aimed to evaluate the associations between physical exercise, diet quality, and total fluid intake, along with fluid recommendations compliance in a sample of adults. Data on fluid intake from different types of beverages were collected in a cross-sectional study, in 1161 men and women between 18 and 65 years of age, using a fluid-specific diary. Exercise was evaluated with a self-reported questionnaire, and quality of diet was assessed using the Healthy Eating Index-2010 (HEI). Mean volume of water consumed was 1497.5 mL for men, 1309.5 mL for women. A total of 37.4% did not follow the recommendations of the European Food Safety Agency for total water intake. There was a statistically significant difference (P = .002) between total water intake and follow-up of recommendations, as well as for sex (P < .001). Mean HEI-2010 score was 65.21. There were no statistically significant differences (P = .301) in HEI index among better or worse hydration. Sport variables had influence on milliliters of water consumed (P < .001). Participants who engaged in more physical exercise exhibit a healthier pattern of fluid intake. Healthy individuals with the highest scores for HEI-2010 did not present the healthiest beverage patterns.

Radioiodine therapy activity 550 MBq of I131 in thyrotoxicosis patients

Background. Radioiodine therapy (RIT) is an alternative method to surgical treatment used in the treatment of hyperthyroidism (Graves’ disease or solitary/multinodular toxic goiter (STG/MTG) etiology). However, treatment protocol doesn’t exist. Aim. To evaluate the outcomes of the I131 treatment in hyperthyroidism using the standard dose (550 Mbq), and to explore the factors that influence the outcome of treatment. Methods. We studied 38 patients (35 women and 3 men) with hyperthyroidism. Each patient was carried I131 RIT in a dose of 550 Mbq. Patients were randomized 2 group – patients with Gravesa disease and patients with a solitary/multinodular toxic goiter. Antithyroid drugs withdraw was usually conducted for 7–14 days prior to RIT. Follow-up period ranged from 6 to 8 months, the average was 6.6 ± 0.4 months. Results. Six months after the RIT 23 patients (61%) reached hypothyroidism, 7 patients (18%) was observed euthyroidism, thyrotoxicosis stayed in 8 patients (21%). In patients with Gravesa disease onset hypothyroidism were more likely (75% vs 35.7%, p < 0.001). Thus at STG/MTG achieve euthyrosis percentage was higher (28.6% vs 12.5%). Predictors of a positive outcome of the treatment are: less thyroid size (<30 ml for women, <40 ml for men) and younger age (under 35 years old). Statistical significance in influencing the outcome of treatment by disease duration, level of stimulating antibodies against thyrotropin receptors have not been identified. Conclusions. Fixed activity of 550 MBq I131 has a different efficacy in the treatment of hyperthyroidism in patients with Graves’ disease and STG/MTG. In addition, on treatment results affect patient age and the size of the thyroid gland, which should be considered during planning RIT. In order to improve the effectiveness of radioiodine therapy of hyperthyroidism requires personalization tactics of treatment based on clinical factors, as well as the use of in vivo dosimetry planning when therapeutic activity calculating.

Functional and Anatomic Responses of the Left Atrium to Change in Estimated Left Ventricular Filling Pressure.

Left atrial (LA) remodeling and dysfunction reflect chronic exposure to elevated left ventricular (LV) filling pressures. The aim of this longitudinal cohort study was to define the effect of reducing LV filling pressures on reverse remodeling of LA volume (LAV) and function. This retrospective cohort included 195 patients (52% men; mean age, 64 ± 14 years) in sinus rhythm with LA dilatation and sequential echocardiograms (median interval, 1 year; interquartile range, 0.5-2.0 years). One hundred seventy-four patients underwent medical therapy (82 with reduced E/e' ratios), and 21 underwent surgery for valvular heart disease. Biplane LAV (normal value, ≤ 68 mL for men, ≤ 62 mL for women), LA strain (ε) (normal value, >32%) and LV filling pressures (assessed as E/e' ratio; normal value, <13) were measured. Although LAV at baseline and follow-up were 88 ± 27 and 81 ± 24 mL, LA ε and E/e' ratio remained stable at 26 ± 11% and 14 ± 7, respectively. Changes in E/e' ratio were associated with changes in LAV (r = 0.37, P < .001) and LA ε (r = -0.51 P < .001). Although reduced E/e' ratio or improved LA ε at follow-up occurred in about 50% of the patients, only 26% (51 of 195) had normalized LAV. Compared with surgery, successful reduction of E/e' with medical therapy was less effective in reducing LAV (P < .001) but produced similar improvement in LA ε. Having normal or improved E/e' ratio at follow-up was not associated with normalization of LAV (relative risk, 1.29 [P = .326] and 1.22 [P = .421], respectively) but was associated with normalized LA ε (relative risk, 2.04 [P = .011] and 1.86 [P = .017], respectively) independently of LAV. Reduction in LV filling pressures reduces but rarely normalizes LAV. The strong association of reduced LV filling pressure with improved LA function indicated by LA longitudinal ε supports the increasing interest of LA ε measurement.

Hydration profile and sweat loss perception of male and female division II basketball players during practice.

Hydration affects multiple aspects of basketball performance, but few investigations have examined the hydration profiles of collegiate basketball players. We examined multiday prepractice hydration status of 11 male and 11 female NCAA (National Collegiate Athletic Association) Division II basketball players' sweat losses, fluid intake, and how accurately players estimated their sweat losses. Urine-specific gravity (USG) was spontaneously assessed before 2 practices. Sweat losses and fluid intakes were measured during a conditioning practice (CP) and sport-specific practice (SP). After practices, players filled 1,030 ml practice bottles to estimate their sweat losses. Urine-specific gravity between practices exhibited a moderate correlation (r = 0.54; p = 0.012) and were consistently high (17% of samples = USG >1.030) with no difference in mean USG between men (1.026 ± 0.004) and women (1.022 ± 0.008). Athletes' estimations of their sweat loss volumes between CP and the longer SP were strongly correlated (r = 0.88; p < 0.001). Estimation error was high (absolute error for both practices = 71 ± 52%) and error direction varied greatly within men. Women consistently underestimated sweat losses by 63 ± 28% and 65 ± 20% during CP and SP. Sweat losses during SP equaled 2,471 ± 495 ml and 1,910 ± 441 ml for men and women, respectively, but high practice fluid intake limited body mass losses to 1.1 ± 0.6% by the end of practice. It is plausible that hypohydration is related to poor conceptualization of sweat losses. Simulating the methodology of this study could help identify chronically hypohydrated athletes and be used to educate on between-practice fluid needs.

Mold Odor and Lung Function in Adults with Asthma

Background: Indoor dampness and molds are common exposures worldwide. One previous study has addressed effects of such exposures at home on lung function in adult asthmatics, who may form a susceptible group. We investigated the effect of dampness and mold exposures at home and at work on lung function among adults with new asthma. We elaborated the importance of different exposure indicators. Methods: In a population-based study 521 (response rate 86%) working-aged adults with clinically defined incident asthma from South Finland answered a questionnaire on indoor dampness and mold exposures at home or at work and other factors potentially influencing lung function, and 487 performed spirometry. Results: Among asthmatics reported exposure to mold odor at home or at work or both was related to a significantly reduced FEV1 level (-240 ml, 95% CI -480 ml to -3 ml) compared to those with no such exposure. FVC showed a similar, but statistically nonsignificant association (-160 ml, 95% CI -390ml to 60 ml). The relation with mold odor was detected mostly in men (FEV1 change on average -480 ml in men and -90 ml in women) and an exposure-response pattern was seen among men. The other dampness-related exposures did not show consistent associations with lung function. Conclusions: This study provides new evidence that among working-aged adults with new asthma, mold odor at home or at work is related to reduced FEV1 level. Men seemed to be more susceptible to this effect. This finding suggests that microbes are important causal agents. The results indicate that those with asthma should be protected from being exposed to indoor molds.

Current prevalence of goiter determined by ultrasonography and associated risk factors in a formerly iodine-deficient area of Turkey

The aim of this study was to determine the prevalence of goiter and related risk factors in an adult population in a formerly iodine-deficient area of Turkey. In this cross-sectional study, we enrolled 2,500 subjects (1,270 women and 1,230 men, aged over 20 years) by multistage sampling. Blood and urine specimens were collected for the assessment of thyroid function. Thyroid ultrasonography (USG) was performed to measure thyroid volume and evaluate nodules. The overall goiter prevalence was 26.5 % (28.4 % in women, 24.5 % in men, P < 0.05). Median thyroid volume was 15.59 mL (13.65 mL in women, 17.96 mL in men, P < 0.0001). Median urinary iodine was 122.79 μg/L. USG revealed thyroid nodules in 35.2 % of the subjects (38.4 % in women, 31.8 % in men, P < 0.005). Age group analysis revealed the lowest rate in the 20-29-year age group (12.5 %), which increased with age, reaching the highest level (38.4 %) in the 70+ years age group. The prevalence of goiter was negatively correlated with education level and positively correlated with body mass index (BMI) and positive family history. According to occupation, goiter prevalence was highest in farmers (35.3 %) and housewives (32.2 %). Despite a normal range of current urinary iodine excretion levels, prevalence of goiter in this adult population in a formerly iodine-deficient province of Turkey remained high, even about 10 years after salt iodine supplementation program introduction. In addition, the goiter prevalence was higher for female gender, advanced age, positive family history of goiter, low education level, and high BMI.

Gender Differences in the Relationship Between Age-Related Carotid Intima-media Thickness and Cardiac Diastolic Function in a Healthy Chinese Population

BackgroundVentricular-arterial coupling is a key determinant of cardiovascular performance. However, little is known about the gender differences in ventricular-arterial interactions in the healthy Chinese population. ObjectiveTo identify gender differences in the association between carotid intima-media thickness (CIMT) and cardiac diastolic function in healthy Chinese individuals. Methods and ResultsWe examined 852 healthy participants (aged 30–98 years, 46% men) in 3 northern China cities with the use of M-mode ultrasonography to analyze CIMT and cardiac structure and function. Cardiac function was measured by determining the ratio of early-diastolic peak flow velocity (E) and late-diastolic peak flow velocity (A), as well as the deceleration time of the early mitral velocity (MV-DT). Cardiac dysfunction was defined as E/A values <25th percentile (E/A <0.78 for men and <0.79 for women), left atrial volume (LAV) values >75th percentile (LAV >34.9 mL for men and >32.2 mL for women), and MV-DT values >75th percentile (MV-DT >210 ms for men and >195 ms for women). CIMT, E/A, LAV, and MV-DT were significantly correlated with age in both men (CIMT: r = 0.418, P < .01; E/A: r = −0.325, P < .01, LAV: r = 0.123, P < .05; MV-DT: r = 0.175, P < .01) and women (CIMT: r = 0.429, P < .01; E/A: r = −0.423, P < .01; LAV: r = 0.180, P < .01; MV-DT: r = 0.174, P < .01). Interestingly, left ventricular ejection fraction (LVEF) was not significantly correlated with age in either gender. CIMT was significantly associated with a lower E/A in an unadjusted model in tertiles II and III. The odds ratios (95% confidence interval [CI]) for men were 2.428 (1.36–4.335) and 3.017 (1.674–5.437), respectively. However, this association disappeared with age adjustment. The odds ratios (95% CI) for women were 3.298 (1.742–6.246) and 6.002 (3.202–11.251), respectively, and these were still significant after adjustments for all other variables, including age, blood pressure, blood lipid, and inflammatory markers (tertile II: 3.031, 95% CI 1.228–7.48; tertile III: 3.224, 95% CI 1.308–7.946). A higher MV-DT was significantly correlated with higher CIMT only in an unadjusted model for women, and this association was lost with age adjustment. There was no significant association between CIMT and higher LAV values. ConclusionsAge-related increases in CIMT were correlated with a decline in cardiac diastolic function only in women, which may contribute to the higher incidence of heart failure with preserved ejection fraction.

2267 DETRUSOR OVERACTIVITY: DO THE DIFFERENT PATTERNS HAVE CHARACTERISTICS RELATED TO GENDER OR CLINICAL CONDITION?

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamics Testing1 Apr 20132267 DETRUSOR OVERACTIVITY: DO THE DIFFERENT PATTERNS HAVE CHARACTERISTICS RELATED TO GENDER OR CLINICAL CONDITION? Françoise Valentini, Brigitte Marti, and Gilberte Robain Françoise ValentiniFrançoise Valentini Paris, France More articles by this author , Brigitte MartiBrigitte Marti Paris, France More articles by this author , and Gilberte RobainGilberte Robain Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2196AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Two patterns of detrusor overactivity (DO) are defined: phasic (DOP) and terminal (DOT) (1). Are there differences in pattern and characteristics according to age, gender, complaint and neurological status. In that last condition, are there differences according to the level of neurological injury? METHODS Retrospectively, 203 files of DO patients have been analyzed (127 women and 76 men, respectively 48 and 43 had neurological disease). Each gender was separately analyzed. Studied parameters were pattern of DO and characteristics of non-inhibited detrusor contraction (NIDC). RESULTS 1) DOP patients were significantly younger in the whole population (56±19 vs. 66±4 y; p<.0001) and whatever gender (56±19 vs. 65±15 y for women, p=.0052 and 57±18 vs. 68±12 for men, p=.0038). 2) Frequency of urgency was similar in DOP and DOT: 80.0 vs. 83.6% for women and 72.0 vs.79.5% for men. 3) Between both genders, there was neither difference in characteristics of NIDC #1: volume of occurrence (148±103 vs. 186±122 mL), amplitude which was nearly significant (13.1±10.7 vs. 18.5±16.4 cmH2O; p=.0535), rise time (7.7±3.2 vs. 8.8±5.1s), nor in number of NIDC (3.2±1.7 vs. 3.8±3.1). There was a significant increase of NIDC amplitude during bladder filling whatever the gender and a significant difference of last NIDC amplitude between women and men: 27.8±21.5 vs. 44.5±33.8 cmH2O (p=.0056). 4) For women, NIDC #1 occurred at significantly smaller volume in non-neurological (125±89 vs. 185±116 mL, p=.0223); NIDC at bladder functional capacity was more frequent in older women (60.3±18.3 vs. 47.4±19.3 y, p=.0103). 5) In the whole population, there was no difference in volume of occurrence of DOT: 228±127 mL for women vs. 253±138 mL for men. 6) For women with DOT, NIDC occurred at larger volume in non-neurological (274±126 vs. 153±90 mL, p=.0001), no difference in men. CONCLUSIONS The only difference between the patterns of DO is that DOP occurs in younger individuals. Except an expected higher detrusor pressure during the last NIDC in men with DOP, there is no significant difference between characteristics of each pattern whatever gender, complaint and neurological status. 1-NAU 2002; 21: 167-178 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e929-e930 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Françoise Valentini Paris, France More articles by this author Brigitte Marti Paris, France More articles by this author Gilberte Robain Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Cold-activated brown adipose tissue is an independent predictor of higher bone mineral density in women

In animals, defective brown adipogenesis leads to bone loss. Whether brown adipose tissue (BAT) mass relates to bone mineral density (BMD) in humans is unclear. We determined the relationship between BAT mass and BMD by cold-stimulated positron-emission tomography (PET) and dual-energy X-ray absorptiometry (DXA) in healthy volunteers. Higher BAT mass was associated with higher BMD in healthy women, but not in men, independent of age and body composition. Contrary to the traditional belief that BAT is present only in infants, recent studies revealed significant depots of BAT present in adult humans. In animals, defective brown adipogenesis leads to bone loss. While white adipose tissue mass is a known determinant of BMD in humans, the relationship between BAT and BMD in humans is unclear. We thus examined the relationship between BAT and BMD in healthy adults. BAT volume (ml) and activity (standard uptake value) were determined by 18F-fluorodeoxyglucose PET after overnight mild cold exposure at 19 °C, and BMD was determined by DXA. Among 24 healthy adults (age 28±1 years, F=10), BAT volumes were 82.4±99.5 ml in women and 49.7±54.5 ml in men. Women manifested significantly higher BAT activity, by 9.4±8.1% (p=0.03), than men. BAT volume correlated positively with total and spine BMD (r2=0.40 and 0.49, respectively, p<0.02) in women and remained a significant predictor after adjustment for age, fat, and lean body mass (p<0.05). Total and spine BMD were higher in women who harbored visually detectable BAT on PET images than those without by 11±2% (p=0.02) and 22±2% (p<0.01), respectively. No associations were observed between BAT parameters and BMD in men. This study demonstrated higher BMD among healthy women with more abundant BAT, independent of age and other body compositional parameters. This was not observed in men. The data suggest that brown adipogenesis may be physiologically related to modulation of bone density.

Chronic urinary retention in men: How we define it, and how does it affect treatment outcome

What's known on the subject? and What does the study add? Chronic urinary retention (CUR) is a poorly defined entity, as the key element of definition, significant postvoid residual urine volume (PVR), has not a worldwide and moreover evidenced-based definition. There is no agreement on which is the threshold value to define a significant PVR and different society produced guidelines with different thresholds ranging from 300 mL to 1000 mL. Diagnosis is difficult, and management has not been defined yet. There is a lack of studies on the best management of these patients, as this group of patients has always been considered at high risk of failure. Only one study compares conservative with the surgical management but it is not a randomised controlled trail. This review offers a systematic appraisal of the most recent publications on CUR. It indicates the absence of a real worldwide agreed definition, as the two keys element of it are not satisfactorily defined yet: significant PVR, is suffering from a lack of evidenced-based definition, and percussable or palpable bladder is a very nebulous concept as it is not a criteria of certainty as different individual variables affect it. This has an important effect on management which is not structured. Most of the trials involving benign prostatic hyperplasia treatments (either medical or surgical) tend to exclude this group of patients, which is a clinically important group, comprising up to a quarter of men undergoing TURP in the UK. Urinary retention describes a bladder that does not empty completely or does not empty at all. Historically, urinary retention has been classified as either acute or chronic the latter is generally classified as high pressure or low pressure according to the bladder filling pressure on urodynamic. A MEDLINE® search for articles written in English and published before January 2010 was done using a list of terms related to urinary retention: 'urinary retention', 'chronic urinary retention' and 'PVR'. Chronic urinary retention (CUR) is defined by the International Continence Society as 'a non-painful bladder, which remains palpable or percussable after the patient has passed urine'. Abrams was the first to choose a residual urine volume >300 mL to define CUR as he considered it the minimum volume at which the bladder becomes palpable suprapubically. The UK National Institute for Health and Clinical Excellence lower urinary tract symptoms (LUTS) guidelines define CUR as a postvoid residual urine volume (PVR) of >1000 mL. No studies have specifically addressed the problem of quantifying the minimum amount of urine present in the bladder to define CUR. Nor did we find any publications objectively assessing at what amount of urine a bladder can be palpable. The ability to feel a bladder may rely on variables (i.e. medical skills and patient habitus). There is a marked variability of PVR, so the test should be repeated to improve precision. As defining CUR is difficult, structured management is challenging. Nearly all prospective trials exclude men with CUR from analysis, possibly anticipating a poor outcome and a high risk of complications. However, men with CUR are a clinically important group, comprising up to 25% of men undergoing transurethral resection of the prostate. Definition of CUR is imprecise and arbitrary. Most studies seem to describe the condition as either a PVR of >300 mL in men who are voiding, or >1000 mL in men who are unable to void. This confusion leads to an inability to design and interpret studies; indeed most prospective trials simply exclude these patients. There is a clear need for internationally accepted definitions of retention to allow both treatment and reporting of outcomes in men with LUTS, and for such definitions to be used by all investigators in future trials.

Abstract P355: Sodium and Potassium 24 Hours Excretion in The Italian Adult Population: Preliminary Results of The MINISAL-GIRCSI Study

Background: According to the recommendation of the High Level Group of the European Union within the “Gaining health: make healthy choices easy choice” Preventive Program of the Italian Ministry of Health, the agreement with bread makers' associations was signed for the gradual reduction of the salt content in bread. In Italy, information about habitual sodium and potassium intake is scanty. In order to monitor preventive actions of this Preventive Programme the MINISAL-GIRCSI Study is to assess the dietary intake of sodium and potassium in representative samples of the Italian adult population. Methods: Baseline data from 12 different random samples collected within the MINISAL-GIRCSI-Health Examination Survey started in 2008, with completed screening and laboratory determinations, were considered: 1196 men and 1231 women aged 35-79 years. Sodium and potassium daily intakes were assessed through 24-hour urine collection using standardized procedures. Determinations of sodium, potassium and creatinine were assessed in a centralized laboratory. Information on habit of adding salt to food and the consumption of high salt content food were collected through a questionnaire. Results: Mean of sodium chloride per day resulted 11 g in men and 8 g in women with a range of 1-27 g and 2-27 g respectively. Mean of potassium chloride per day resulted 5 g in men and 4 g in women with a range of 1-13 g and 1-9 g respectively. Mean of creatinine per day resulted 1463 mg in men and 942 mg in women. Mean of urine volume per day resulted 1861 ml in men and 1827 ml in women. In both men and women, higher intake of sodium chloride was found in Southern regions; no geographical differences were found for potassium chloride. Sodium and potassium chloride excretions were not found higher with increasing age. Most of persons (72%) eat three slices of bread per day and 22% eat cheese and processed meat more than 4 times per week. Thirteen percent of persons usually add salt during meals and 19% are usually thirsty after meals. Conclusions: Preliminary results show that Italian adult population take more than double of WHO recommended salt intake; this is typical in industrialized countries. Further analyses considering data from other Italian regions are needed to confirm these values. The prevention actions at population level should include recommendations for reducing salt intake.

Cerebellar and cerebral grey and white matter volumes: The Rotterdam Study

In research about aging of the brain, many researchers have showed an interest in supratentorial atrophy. Although population-based studies have widely investigated structural properties of the cerebrum, the cerebellum has received little attention. Studies in the general population on structural properties of the cerebellum are scarce. In a population-based study of community dwelling elderly we sought to investigate properties of the cerebellum to create normative estimates; to study the relationship with age and sex; and to study the interrelationship with cerebral volumes. The study is based on the Rotterdam Scan Study, an ongoing population-based cohort study investigating age-related brain changes on MRI. We included 3962 persons (mean age 60.2 years (SD 8.6), 54.4% women) with complete MRI scans. Cerebellar and cerebral volumes were calculated using Freesurfer1. We used linear regression analyses to calculate the relationship between age, sex, and volumetric properties of the cerebellum and cerebrum. Average intracranial volume was 1491.0 mL. Cerebellar volume was 134.3 mL in men and 122.4 mL in women. Cerebellar grey matter volume was 102.8 mL and white matter volume was 25.0 mL. Mean cerebral grey matter was 437.1 mL, white matter was 455.1 mL. The ratio of grey and white matter in the cerebellum showed a difference between males and females (p < 0.001). This was not found for the cerebrum (p = 0.56). Age-related volume loss was 0.24 mL per year for cerebellar grey matter (p < 0.001), and 0.11 mL per year for cerebellar white matter (p < 0.001). In the cerebrum the volume loss per year was 0.96 mL (p < 0.001) for grey matter and 1.54 mL for white matter (p < 0.001). Cerebellar and cerebral volumes are larger in men than in women. The ratio of grey and white matter volumes is different for cerebellum and cerebrum. Cerebellar grey matter showed a larger age-related decline than cerebellar white matter, while in the cerebrum, a larger volume loss was found in white matter tissue. These data can serve as a reference for future studies on cerebellar volumes. 1. Fischl, B. et al. 2002. Neuron 33, 341-355.

Normal values for renal parenchymal volume and kidney length as measured by non-enhanced multidetector spiral computed tomography

Renal parenchymal volume (RPV) is considered an important index for clinical decisions. However, normal values have not been established, which hinders the clinical application of RPV. To test the accuracy and reproducibility of RPV and to investigate the normal values of RPV and kidney length as measured by non-enhanced multidetector computed tomography (CT). An animal model study was performed to test the accuracy and repeatability of RPV measured by CT. RPV of porcine kidneys was measured by water displacement (actual values) and non-enhanced multidetector CT. Individual RPV and kidney length were measured by non-enhanced CT in patients with no clinical history of renal disease (n = 722). Patient height, age, weight, body surface area (BSA), and body mass index (BMI) were assessed before each patient's CT examination was performed. RPV obtained by the CT method was within 2% of the RPV determined by the water displacement method. The normal values of RPV (M ± 1.96 standard deviation [SD]) were 145.72 ± 54.37 mL for men and 132.46 ± 41.94 mL for women. The normal values of kidney length (M ± 1.96 SD) were 10.27 ± 1.98 cm for men and 9.93 ± 1.58 cm for women. RPV did not significantly correlate with BSA or weight in women, but correlated significantly with height and age in both men and women. Of the assessed factors age, weight, height, BSA, and BMI, age, and height were the independent factors that best reflected RPV, in both men and women. The present animal study results showed that non-enhanced multidetector CT findings accurately reflect the RPV. The subsequent study performed in humans showed that the RPV of the presently sampled Chinese population was lower than the commonly quoted reference values obtained from Western populations.

Can Pinaverium Bromide Plus Simethicone Improve Bloating and Objective Abdominal Distention During a 12-Week Randomized-Clinical Trial in IBS? A Report From the Mexican IBS-Working Group

Background: Bloating and objective abdominal distention are considered gas-related symptoms and while they are related, they may represent expressions of different underlying pathophysiological process and have different response to treatment.1-2 Therefore, the efficacy of 100 mg pinaverium bromide + 300 mg simethicone (PB+S) over these symptoms, was studied in a 12-week randomized placebo-controlled trial. Methods: We studied 285 IBS-Rome III patients. They all filled-out a 12-week questionnaire that included 10-cm visual analog scales (VAS) for evaluating the intensity abdominal pain and bloating, and registered their girth circumference (objective distension) early in the morning and before bedtime during weeks 1, 6 and 12 of treatment. Data was analyzed with ANOVA for repeated measurements, using as covariate the linear combination of the girth measurements during all the weeks (explained 78% to 80% of the total variance). Finally, the abdominal volume was calculated with a mathematical model: (circumference cm)3/[6π2]. Results: Patients were 37±9 years old, F: 83%, BMI: 27±5, and were classified as IBS-C: 44%, IBS-D: 23%, IBS: 31%, and IBS-U: 2%. They reported a significant decrease in abdominal pain and bloating favoring PB+S vs. placebo (Size effect: 23% and 21% respectively, p<0.05 for both). Abdominal girth increased at night vs. morning with a mean difference of 1.8±0.2 cm, and between basal and the other weeks: 0.9±0.3 cm (Both: p<0.05). However, there were no differences in PB+S vs. placebo. Themathematical model showed difference betweenmorning and night for women: 800 mL and men: 1000 mL. The calculated abdominal volume between the basal measurement and the combination of weeks 4th and 6th were 400 mL for women and 500 mL for men. Conclusions: PB+S is effective for improving abdominal pain and bloating with no differences on objective distention. These findings suggest that BP+S may improve the gas-related symptoms through an effect on visceral perception or that measuring waist circumference is not sensitive enough to detect subtle changes in the volume of intestinal gas. Future studies should explore if distension triggers abdominal pain. 1. Chang L, et al. Am J Gastroenterol. 2001;96:3341-7. 2. Azpiroz F, Malagelada JR. Gastroenterology. 2005;129:1060-78.

Ambulatory blood pressure profile in hypertensive patients with β-thalassemia minor

β-thalassemia trait (β-TT) is a common genetic disorder in Mediterranean countries, including Greece. Previous studies have shown the protective effect of β-TT against myocardial infarction. However, the ambulatory blood pressure (BP) profile of such patients has not yet been investigated. Thus, the purpose of the present study was to investigate the ambulatory BP monitoring (ABPM) profile of hypertensives with β-TT, in comparison with all-cause anemic and non-anemic essential hypertensive patients. The study ultimately comprised of 8861 essential hypertensive, nondiabetic patients who were divided into three groups: group I (n=191, with β-TT), group II (n=655, anemic) and group III (n=8015, nonanemic). All patients underwent full clinical, laboratory and echocardiographic evaluations, whereas all were subjected to ABPM. Anemia was defined as Hb <12 g per 100 ml for women and <13 g per 100 ml for men, whereas patients with β-TT were self-referred. The distribution of dipping patterns among the three groups was 61.3 vs. 41.2 vs. 45.8% (P<0.001), whereas for nondippers it was 20.4 vs. 31.5 vs. 27.7% (P<0.001), for extreme-dippers it was 15.7 vs. 15.0 vs. 17.5% (P<0.001) and for reverse dippers it was 2.6 vs. 12.4 vs. 9.0% (P<0.001). Furthermore, mean daytime systolic BP (SBP) among the three groups was 140.13 ± 7.79 vs. 142.02 ± 11.61 vs. 141.99 ± 9.87 mm Hg (P=0.03), and mean nighttime SBP was 125.87 ± 10.4 vs. 131.13 ± 15.7 vs. 129.62 ± 13.31 mm Hg (P<0.001). In the multiple regression analysis, after adjustments for age, body mass index and lipid levels, the differences among daytime and nighttime SBP remained significant at 140.18 ± 9.84 vs. 142.02 ± 9.85 vs. 141.99 ± 9.85 mm Hg (P=0.04) and 125.99 ± 13.07 vs. 131.19 ± 13.08 vs. 129.61 ± 13.07 mm Hg (P<0.001), respectively. Hypertensive patients with β-TT present with a better 24-h BP profile in comparison with anemic and nonanemic hypertensives. Thus, β-TT may function protectively in their total cardiovascular risk profile.