Sexual Disturbances Research Articles

Sexual behavior and testis morphology in the BACHD rat model.

BackgroundHuntington disease (HD) is an autosomal dominant neurodegenerative disorder caused by a mutation in the huntingtin (HTT) gene, which results in brain neurodegeneration and peripheral pathology affecting different organs including testis. Patients with HD suffer from motor and cognitive impairment, and multiple psychiatric symptoms. Among behavioral abnormalities in HD, sexual disturbances have often been reported, but scarcely investigated in animal models. The BACHD rat model of HD carries the human full-length mutated HTT (mHTT) genomic sequence with 97 CAG-CAA repeats and displays HD-like alterations at neuropathological and behavioral level.ObjectiveThis study aims to phenotype the BACHD rats’ sexual behavior and performance as well as testis morphology because alterations in these aspects have been associated to HD.MethodsTwo rat cohorts at the age of 3 and 7 months were subjected to mating tests to assess different parameters of sexual behavior. Histological analyses for testis morphology were performed in different rat cohorts at 1.5, 7 and 12 months of age whereas immunohistochemical analyses were carried out at 7 and 12 months of age to visualize the presence of mHTT in testicular tissue. Furthermore, western blot analyses were used to assess HTT and mHTT expression levels in striatum and testis at three months of age.ResultsAt 3 months, BACHD rats showed a decreased time exploring the female anogenital area (AGA), decreased latency to mount, increased number of intromissions and ejaculations and enhanced hit rate. At 7 months, all sexual parameters were comparable between genotypes with the exception that BACHD rats explored the AGA less than wild type rats. Testis analyses did not reveal any morphological alteration at any of the examined ages, but showed presence of mHTT limited to Sertoli cells in transgenic rats at both 7 and 12 months. BACHD rat HTT and mHTT expression levels in testis were lower than striatum at 3 months of age.ConclusionsThe testis phenotype in the BACHD rat model does not mimic the changes observed in human HD testis. The altered sexual behavior in BACHD rats at three months of age could be to a certain extent representative of and share common underlying pathways with some of the sexual disturbances in HD patients. Further investigating the biological causes of the sexual phenotype in BACHD rats may therefore contribute to clarifying the mechanisms at the base of sexual behavior changes in HD.

2120 Long-acting reversible contraceptive uptake in female sex workers and single mothers in Rwanda and Zambia

OBJECTIVES/SPECIFIC AIMS: Long-acting reversible contraception (LARC) has been well established as the most cost-effective form of contraception, but LARC usage in developing countries remains low. As part of a multi-center parent study on HIV incidence, we implemented an integrated family planning program to increase LARC uptake in single women in Rwanda and Zambia. We aim to evaluate rates of LARC uptake, LARC discontinuation and incident pregnancy following family planning counseling. METHODS/STUDY POPULATION: We enrolled 3 cohorts of single sexually active HIV-negative women between the ages of 18–45 years: single mothers (SM) in Zambia, female sex workers (FSW) in Zambia and FSW in Rwanda. Participants were followed every 3 months for up to 5 years. At each visit, we discussed fertility goals and counseled participants on HIV risk reduction and contraceptive options. Eligible participants (not pregnant, already using a LARC method, or using a permanent contraceptive method) were offered a LARC method, specifically the copper IUD or Jadelle implant. Data was collected on demographic factors, sexual behavior, sexual and reproductive history, and gynecological exams and laboratory tests were performed if necessary. RESULTS/ANTICIPATED RESULTS: In total, 458 Rwandan FSW, 555 Zambian FSW, and 521 Zambian SM were enrolled, with a median follow-up time of 6 months, 12 months, and 9 months, respectively. Accounting for any LARC uptake during longitudinal follow-up, our preliminary results show an increase in LARC usage from 21% at screening to 51% at the end of follow-up among Rwandan FSW, an increase from 12% to 42% in Zambian FSW and an increase from 18% to 44% in Zambian SM. We hypothesize that demographic factors (e.g., younger age, higher education level) and sexual history (e.g., greater number of sexual partners, any STIs or reproductive health disturbances) will be associated with increased rates of LARC uptake. We also hypothesize that LARC users will have significantly lower proportions of contraceptive method discontinuation and incident pregnancy compared to non-LARC users. DISCUSSION/SIGNIFICANCE OF IMPACT: FSW and SM are disproportionately affected by high rates of unintended pregnancy, which can lead to obstetric complications and poor psychosocial outcomes. It is imperative that family planning interventions in developing countries target these populations to overcome obstacles in reproductive health and promote gender equality. Our study will provide necessary insights to an integrated family planning program, which will guide future efforts to design, implement and evaluate family planning initiatives for high-risk populations.

THE INFLUENCE OF PSYCHOSOMATIC DISORDERS ON THE DEVELOPMENT OF PSYCHOLOGICAL INFLUENCE

This paper deals with the problems and psychosomatic disorders that occur in couples with family planning. There dislayed data about the features of psychosomatic disorders that contribute to the development of infertility among couples. The causes of the onset of psychological infertility are revealed, which should be sought not only from the side of the woman, but also among men. The role of medical and social research in infertility is shown here. The role of psycho-emotional disorders, that hinder conception, is noted in the article.Objective - the purpose of the work is to analyze the state of the issue of the influence of psychosomatic disorders on the development of psychological infertility in modern medical literature.Conclusions. Having analyzed the available literature sources, it can be argued that the psychosomatic problems of infertility in women and sexual disturbances, both in women and men, are a symbolic manifestation of unconscious conflicts that are not memorized or physical manifestations of "childish" anxieties and fears, which arose as a result of an early psychological breakdown with the mother. It is also an individual stereotype of the emotional response of man and the influence of suppressed emotions on one or another body system.These manifestations can be successfully treated with the help of katarimno imaginative psychotherapy (symbols). In most practical cases, using this method of psychotherapy, mediation sessions, visiting informative lectures, it is possible to overcome all the manifestation of the problems that arise in marital couples and thus avoid infertility.

Autonomic Dysfunction in Iraqi Patients with Chronic Inflammatory Demyelinating Polyneuropathy

Objective:The purpose of this study is to evaluate the autonomic disturbance in patients with chronic inflammatory demyelinating polyneuropathy.Methods:Thirty-eight patients who fit into the AAN criteria of diagnosis of CIDP were studied. Five standard cardiovascular autonomic Ewing tests were performed for every patient in addition to the assessment of autonomic symptoms.Results: The study includes 32 males and 6 females their age ranged from 10 to 69 years. In this study we have seen one child with CIDP whose age was ten years and he had PST impairment. Sexual disturbance was the majorautonomic symptom seen in the males [40.6%], while urinary disturbance 2was the major autonomic disturbance encountered in females [66.6%]. Autonomic function tests [AFT] showed that one quarter of males and half of the females had abnormal AFT. In patients aged between 50-59 years, [40%] having normal autonomic function test, [40%] had PST impairment, while the others have mixed impairment [20%]. None of the patients had pure sympathetic impairment. Regarding the types of CIDP the largest percent [84.2%] of patients have classic type of CIDP while 7.8%, 5.2% and 2.6% had DADS, MADSAM and MMN respectively.Conclusions: Autonomic dysfunction was common in Iraqi CIDP patients. PST impairment is a major pattern of dysautonomia in CIDP. Sexual disturbance in males while urinary disturbance in females were the most common autonomic symptoms encountered. VM, HR response to standing allow an early detection of autonomic dysfunction even in asymptomatic individuals.

Impact of Kidney Transplantation on Reproductive Hormone Levels in Males: A Longitudinal Study

Background/Aims: Male patients with end-stage renal disease suffer from sexual disturbances and infertility. Disturbances in the hypothalamic-pituitary-gonadal axis are one of the causes of this. Decreased testosterone synthesis in Leydig cells of the testes and hyperprolactinemia are common. Kidney transplantation, unlike hemodialysis, normalizes these changes. However, how kidney transplantation affects Sertoli cell function is poorly understood. This study is aimed at investigating the changes in fertility-related hormones in men before, during, and after renal transplantation. Methods: This longitudinal and prospective single center study enrolled 12 men undergoing living donor kidney transplantation. Plasma levels of creatinine, cystatin C, and serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, sex hormone-binding globulin, inhibin B, and anti-Müllerian hormone (AMH) were assayed at 10 different time points before, during, and after kidney transplantation. Results: A rapid decrease in creatinine and cystatin C levels indicated successful renal transplantation. High pre-transplantation plasma levels of prolactin (mean 516 ± 306 mIE/L) and LH (9.4 ± 4.7 IU/L) were normalized after 7 days (248 ± 161 mIE/L and 6.1 ± 3.1 IU/L, respectively). Testosterone decreased rapidly during transplantation and increased again one week post-transplantation. Sertoli cell-derived hormone inhibin B decreased after transplantation, and there was a small non-significant trend of increased AMH after 12 months. Conclusion: Sertoli cell function, based on AMH and inhibin B levels, does not improve to the same extent or as fast as Leydig cell function after kidney transplantation, as determined by testosterone and LH levels.

Are there gender differences in those diagnosed with psychogenic nonepileptic seizures?

ObjectiveThe objective of the study was to determine whether male and female populations of patients with psychogenic nonepileptic seizures (PNES) differ, in terms of demographic, social/clinical, and etiological factors as well as psychological measures. BackgroundPsychogenic nonepileptic seizures are overrepresented by females; therefore, information about PNES in males is limited. Only a handful of studies have examined PNES and gender, and of those, one was a literature review and with the exception of two, most have had small sample sizes. Of the existing literature, differences in abuse type, psychiatric diagnoses, and psychometric results have been observed in the two genders. MethodsThis is a retrospective study of 51 consecutive males and 97 consecutive females with video-electroencephalogram (video-EEG) confirmed diagnosis of PNES. Patients were examined on demographics (age, education, working status), clinical (seizure frequency, trauma type: sexual, nonsexual, age of first trauma), and psychometric measures. The latter included the State Trait Anger Expression Inventory-2 (STAXI-2), Trauma Symptom Inventory-2 (TSI-2), the Coping Inventory for Stressful Situations (CISS), and the Quality of Life Inventory in Epilepsy-31 (QOLIE-31). ResultsWomen reported experiencing significantly more sexual traumas (p=0.007) than men. Women also endorsed significantly higher levels of dissociation (p=0.012) and sexual disturbances (p=0.46). In contrast, men reported significantly greater use of avoidance (p=0.001) as a stress coping strategy and higher levels of depression (p=0.006). ConclusionsGender differences were identified with males reporting a significantly higher use of avoidance (cognitive and behavioral avoidance of stress) and depressive symptoms. Women exhibited significantly higher rates of sexual trauma compared with male counterparts. Consequently, women also had significantly higher rates of trauma symptomatology (dissociation and sexual disturbances) which are often observed in those who have been traumatized sexually. These gender distinctions may support different first-line treatment approaches (e.g., trauma-focused; more traditional cognitive behavioral therapy) depending on the most prominent symptomatology.

Effects of nutraceuticals on sexual satisfaction and lower urinary tract symptoms in a cohort of young-old men.

The aim of this study was to evaluate the effects of nutraceuticals containing multiple supplemental facts (Virherbe®/Rekupros®) on sexual satisfaction and lower urinary tract symptoms (LUTS) in young-old men. In an open-label trial, 40 males (mean age 66±13) with sexual disturbances and mild LUTS but without cognitive/motor impairment and clinical hypogonadism were enrolled. Sexual desire (SD; IIEF-SD domain) and satisfaction (Global Assessment Question; GAQ), the capacity to perform daily activities (evaluated by 6-min walking test [6MWT]), and International Prostate Symptoms Scores (IPSS) were evaluated before and after oral administration of 2 capsules/day of each supplement for 8weeks. The difference from baseline for SD was +2.6 (p<.05) and -4.2 points for IPSS (p<.05), with significance in subscales of urinary streaming/nocturia (p<.01), respectively; 6MWT increased from 507±44 versus 527±58meters (p<.001). GAQ scale-responses showed overall improvement in overall 75% population, with a significant improvement in QoL (p<.01). These changes returned to baseline at 1-month withdrawal follow-up. No adverse events were reported. These supplemental facts improved sexual desire, satisfaction with sex life, physical performance, and LUTS in young-old men, suggesting that they may be effective in patients in whom standard treatments are not suitable.

Normalisation Versus Medicalisation of Sexual Disturbances During Menopause: A Qualitative Research in the Italian Context

Past research has found consistent correlations between menopause and increase in sexual disturbances, but very little research has inquired into the attribution of meanings to this change from the womens’ own perspectives and the role of the negotiating between sexes in the social-construction of the problem. This study aims to investigate how professionals, women diagnosed with hypoactive sexual desire disorder and ordinary people, both men and women, signify this phenomenon in the Italian context. Interviews were conducted by asking participants whether or not they considered the decrease in sexual desire to be a problem, and what this was dependent on. The analysis of the 146 participants’ answers revealed that women with sexual deficit emphasized the need for treating the biological changes of menopause; specialists considered both the gynecological and the psychological components, while ordinary people seemed to ‘normalise’ the problem, encoding it as the effect of menopause; they did not seem to be inclined to turn the situation into a call for help, suggesting the importance of sharing the problem within the relationship and underestimating the organic level of the question. The negotiation between sexes seems to transform a sexual problem into normality.

Editorial Comment.

No AccessJournal of UrologyAdult Urology1 Oct 2017Editorial Comment Jeannette M. Potts Jeannette M. PottsJeannette M. Potts More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.05.082AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Comment." The Journal of Urology, 198(4), pp. 856–857 References 1 : Fears, sexual disturbances and personality features in men with prostatitis: a population-based cross-sectional study in Finland. BJU Int2001; 88: 35. Google Scholar 2 : Clinical and psychological parameters associated with pain phenotypes in women with interstitial cystitis/bladder pain syndrome. J Urol2015; 193: 138. Link, Google Scholar 3 : Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum2007; 36: 339. Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 4October 2017Page: 856-857 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeannette M. Potts More articles by this author Expand All Advertisement PDF downloadLoading ...

Interpersonal Sensitivity as a Mediator Between Cumulative Childhood Traumatic Events and Adult Sexual Disturbance

ABSTRACTPrevious research has shown that cumulative childhood traumatic events are stronger predictors of sexual disturbances than childhood sexual abuse. Additional factors are likely to influence this relationship. Whereas socio-interpersonal factors such as interpersonal sensitivity have repeatedly been shown to be salutogenic in the aftermath of traumatic events, the specific underlying mechanisms are little understood. The aim of the present study was to examine the relationship between cumulative childhood traumatic events and adult sexual disturbances (i.e., the avoidance of sexual contacts, disruptive sexual behavior, poor sexual boundaries, decreased regulation of sexual impulses) and to investigate the role of interpersonal sensitivity as a potential mediator. The sample comprised 100 adult psychiatric in-patients. As expected, cumulative childhood traumatic events were found to be strong predictors of sexual disturbances, with interpersonal sensitivity partially mediating this relationship.

Common behavioral problems among patients with dementia attending in tertiary care hospitals in Dhaka city

Elderly people are increasing day by day both in developing and developed country due to development of new treatment, increased awareness of people and improved health facilities. This present study was conducted with the aim to identify behavioral problems according to severity of dementia. This descriptive cross sectional study was conducted in the Department of Psychiatry and Department of Neuro-medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and in National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka, Bangladesh from September 2013 to March 2015. A total 150 patients were selected purposefully; severity of dementia was graded according to Mini Mental State Examination (MMSE) and another questionnaire was applied to detect behavioral problems of patients. In this study mild dementia was found as the most frequent (38%), followed by severe dementia (35.3%) and moderate dementia (26.7%). The results indicated that behavioral problem was more common in severe dementia. Behavioral problem was more common in severe dementia than in mild and moderate dementia. Among behavioral problems sleep disturbance and sexual disturbance were statistically significant This study provides information about pattern of behavioral problems among patients with dementia. Liaison approach with other discipline may improve quality of life of these patients treatable.Bang J Psychiatry Dec 2014; 28(2): 50-52

The use of nutraceuticals in male sexual and reproductive disturbances: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS).

The use of nutraceuticals in male sexual and reproductive disturbances: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS).

ASSESSMENT OF THE HEALTH RISKS OF THE EXPOSURE TO ORGANOPHOSPHATE AMONG MALES

Over the past 20 years, a great deal of attention has focusedon the impact of endocrine disruptors released in the environmenton animal and human health. Generally, endocrinedisruptors have estrogenic activity. These products interferewith hormone biosynthesis, metabolism, or action resulting ina deviation from normal homeostatic control or reproduction. Our primary objective was to evaluate the possible role of environmental estrogen on sexual disturbance among males. Methods: A cross-sectional study recruited 26 apparently healthy males characteristics of life style, symptoms covering various systems, general examination including, body mass index, waist line, resting blood pressure were done. Venous blood samples were used for detection of both total testosterone & plasma (Butyryl choline esterase (BuChE) activity. Results: the mean age was (36.54 ± 6.04) years with mean BMI of (28.98 ± 5.16) kg/m2. , mean waist (102.78 ± 11.18) cm. 66.7% of the cases were married with 13.3% of them have fertility problem & 20%of sample have sexual problem. 66.7% of the studied group use pesticide at home. The main findings of this study were, regarding hormonal profile; nearly all studied group had hormonal values and acetylecholine esterase (AChE) within the reference range but there is a negative association between organophosphate (OP) pesticides exposure assessed by the AchE as indicator and serum total testosterone levels. AchE was also negatively associated with fruit & vegetables consumption/week; whereas there is a positive association with age.

Impact of thyroid disease on testicular function.

Testis was considered unresponsive to thyroid hormone for a long time. However, like in animals, the presence of thyroid hormone receptors in different testicular cell types was demonstrated also in humans. Accordingly, thyrotoxicosis and hypothyroidism have remarkable effects on testicular function and more extensively on fertility. Thyrotoxicosis and hypothyroidism are associated with changes affecting the endocrine, sexual, or reproductive functions. Particularly, compared with controls, hyperthyroid patients have higher serum SHBG and lower free and bioavailable testosterone concentrations, a higher rate of astheno-zoospermia, oligo-zoospermia, and terato-zoospermia, and a higher prevalence of sexual disturbances, such as premature ejaculation. In hypothyroid patients, hormonal changes are in the opposite direction compared with hyperthyroid patients. Thyroid hormone regulates a number of functions in the testis, such as proliferation and differentiations of non-germ cells, steroidogenesis, and sperm motility. Furthermore, thyroid hormone regulates testicular redox status. Consequently, thyroid hormone excess or deficiency can affect testicular function at different levels. In view of the high prevalence of thyrotoxicosis and hypothyroidism, a considerable part of infertile patients may harbor overt or subclinical thyroid disease. Identification and management of thyrotoxicosis/hypothyroidism associated infertility needs the collaboration of andrologists, endocrinologists, gynecologists, and general practitioners.

P-01-073 The evaluation of the efficacy of medical anamnesis in the assesment of the presence of sexual disturbances in patients after myocardial infarction undergoing cardiac rehabilitation

P-01-073 The evaluation of the efficacy of medical anamnesis in the assesment of the presence of sexual disturbances in patients after myocardial infarction undergoing cardiac rehabilitation

Tadalafil once daily: Narrative review of a treatment option for female sexual dysfunctions (FSD) in midlife and older women.

Female Sexual Disorders (FSD) include a complex, multidimensional, individual experience that can change as an individual age, suggesting that these problems are caused by multiple factors including psychosocial factors, personal relationships, pathologic changes caused by diseases, and pharmacologic influences. Menopause is an important time for middle aged women and postmenopausal physiological changes could have a significant role in the development of FSD. Few is still known about their correct definition and treatment. Their incidence, prevalence and risk factors are difficult to define because of a high level of overlap in the experience of problems with desire, arousal, and orgasm. Little evidences are known about the best therapeutic approach, and both non-pharmacological and pharmacological treatment options have been described. Among these, phosphodiesterase type 5 inhibitors could be an effective option for many subtypes of female sexual disorders, with an improvement in different aspects of sexual function, such as desire, arousal, orgasm and sexual satisfaction. In this paper authors reviewed what is already known about the use of these vasoactive agents, particularly tadalafil, as a treatment option for female sexual disturbances.

The effect of l-thyroxine treatment on sexual function and depressive symptoms in men with autoimmune hypothyroidism.

Thyroid autoimmunity and mild hypothyroidism in women seem to be associated with sexual dysfunction and depressive symptoms. Data concerning similar associations in men are limited. The aim of this study was to investigate sexual functioning and depressive symptoms in men with autoimmune hypothyroidism. The study population consisted of three groups: men with autoimmune overt hypothyroidism (group A), men with autoimmune subclinical hypothyroidism (group B) and healthy euthyroid males without thyroid autoimmunity (group C). Apart from measuring serum levels of thyrotropin and free thyroid hormones and thyroid antibody titers, all included patients completed a questionnaires evaluating male sexual function (International Index of Erectile Function-15: IIEF-15) and assessing the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II) before and after 6 months of levothyroxine treatment. Men with overt hypothyroidism obtained lower scores in all five domains of IIEF-15, while men with subclinical hypothyroidism only in erectile function. The total BDI-II score was higher in groups A than in groups B and C, as well as higher in group B than in group C. L-thyroxine improved erectile function and normalized intercourse satisfaction, orgasmic function, sexual desire and overall satisfaction in group A, as well as normalized erectile function in group B. In group A, L-thyroxine reduced, while in group B tended to reduce total BDI-II. The obtained results suggest that autoimmune hypothyroidism in men is characterized by sexual and mood disturbances and that hypothyroid patients with sexual dysfunction and depressive symptoms benefit from L-thyroxine treatment.

An open label study on Depression Patient's Disability Outcomes: Comparative Evaluation of Escitalopram and Amisulpride

Background Depression is an important global public health problem due to its relatively high lifetime prevalence and significant disability caused by it. The present study was conducted to compare improvement in disability outcome by Amisulpride and Escitalopram among depression patients using WHO-Disability Assessment Schedule (WHO-DAS).Materials and Methods The study was conducted in depression patients for 1 year in the Department of Neuropsychiatry, Nepalgunj Medical College &amp; Teaching Hospital. A total of 117 depression patients were divided into 2 groups. Group I (58 patients) received Amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given Escitalopram at a dose of 10 mg/day. The patients were required to follow up at 4 weeks, 8 weeks and at 15 weeks. The efficacy of the drugs was calculated by Hamilton depression rating scale (HAM-D). The improvement in functional outcome was compared between the two groups by using WHO-Disability Assessment Schedule (WHO-DAS). Appropriate statistical tools using GraphPadInstat 3.0 were used for analysis. p value &lt; 0.05 was considered significant.Results HAM-D score in group receiving Amisulpride at 0 and 15 weeks was 16.92±0.35 and 7.87±0.29 (p&lt;0.0001). HAM-D score in group receiving Escitalopram at 0 and 15 weeks was 17.09±0.39 and 6.63±0.39 (p&lt;0.0001). WHO-DAS score in group receiving Amisulpride at 0 and 15 weeks was 112.54±0.82 and 43.08±1.41 (p&lt;0.0001) respectively. WHO-DAS in group receiving Escitalopram at 0 and 15 weeks was 113.73±1.92 and 40.69±1.49 (p&lt;0.0001) respectively. Intergroup comparison at 15 weeks was insignificant (p&gt;0.05). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation and insomnia were the commonly encountered adverse drug reactions.Conclusion Both Amisulpride and Escitalopram showed improvement in WHO Disability Assessment Score (WHO-DAS) at the end of study period. But intergroup comparison showed no significant difference in the two groups. Journal of Nobel Medical College Vol.5(2) 2016; 37-42

Need for nursing and social care in patients with multiple sclerosis

The need for nursing and social care, as well as factors which determine their appearance and management, are crucial for multiple sclerosis patients. Together with the diagnostic and treatment activities, nursing and social care can contribute to a better satisfaction of patients and their relatives and to a better quality of life. The most frequently reported needs of this specific group of patients are related to movement disorders, fatigue, pain, bowel and bladder or sexual disturbances, and to psychological support. A professional answer to these needs is impossible without the presence of a specifically trained nurse.

Microcystin-LR causes sexual hormone disturbance in male rat by targeting gonadotropin-releasing hormone neurons

Microcystin-LR (MC-LR), which generates strong reproductive toxicity, reduces serum testosterone level without directly damaging Leydig cells. The purpose of this study was to identify the target cells of MC-LR in the rat hypothalamic-pituitary axis and to investigate the underlying mechanisms. We found that the gonadotropin-releasing hormone (GnRH) neurons were the direct target of MC-LR. In vivo results showed that upon exposure to rats, cells around the third ventricle of hypothalamus underwent apoptosis. Gnrh1 expression was steadily decreased. The serum levels of GnRH, luteinizing hormone, follicle-stimulating hormone and testosterone showed a similar pattern of early-stage increase and late-stage decline. After treatment with MC-LR in immortalized hypothalamic (GT1-7) neurons, increase in cellular Ca2+ and ATP resulted in downregulation of the transcriptional activators Oct-1, Otx-2, Pbx1a and Dlx2, and upregulation of the transcriptional repressor c-Jun, which may mechanistically account for the downregulation of GnRH synthesis. Ca2+ and ATP could also stimulate the release of GnRH, contributing to its unique serum release pattern.