Prostate response to prolactin in sexually active male rats

BACKGROUND: The prostate is a key gland in the sexual physiology of male mammals. Its sensitivity to steroid hormones is widely known, but its response to prolactin is still poorly known. Previous studies have shown a correlation between sexual behaviour, prolactin release and prostate physiology. Thus, here we used the sexual behaviour of male rats as a model for studying this correlation. Hence, we developed experimental paradigms to determine the influence of prolactin on sexual behaviour and prostate organization of male rats. METHODS: In addition to sexual behaviour recordings, we developed the ELISA procedure to quantify the serum level of prolactin, and the hematoxilin-eosin technique for analysis of the histological organization of the prostate. Also, different experimental manipulations were carried out; they included pituitary grafts, and haloperidol and ovine prolactin treatments. Data were analyzed with a One way ANOVA followed by post hoc Dunnet test if required. RESULTS: Data showed that male prolactin has a basal level with two peaks at the light-dark-light transitions. Consecutive ejaculations increased serum prolactin after the first ejaculation, which reached the highest level after the second, and started to decrease after the third ejaculation. These normal levels of prolactin did not induce any change at the prostate tissue. However, treatments for constant elevations of serum prolactin decreased sexual potency and increased the weight of the gland, the alveoli area and the epithelial cell height. Treatments for transient elevation of serum prolactin did not affect the sexual behaviour of males, but triggered these significant effects mainly at the ventral prostate. CONCLUSION: The prostate is a sexual gland that responds to prolactin. Mating-induced prolactin release is required during sexual encounters to activate the epithelial cells in the gland. Here we saw a precise mechanism controlling the release of prolactin during ejaculations that avoid the detrimental effects produced by constant levels. However, we showed that minor elevations of prolactin which do not affect the sexual behaviour of males, produced significant changes at the prostate epithelium that could account for triggering the development of hyperplasia or cancer. Thus, it is suggested that minute elevations of serum prolactin in healthy subjects are at the etiology of prostate abnormal growth

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Rectus Femoris Cross-Sectional Area and Muscle Layer Thickness: Comparative Markers of Muscle Wasting and Weakness

Supported by the U.K. National Institute of Health Research (NIHR) (Z.A.P.), the Batchworth Charitable Trust, the Moulton Charitable Foundation, and the NIHR University College London Hospitals Biomedical Research Centre (UCLH BRC) (A.S.M.), the Research Councils UK (S.D.H.), the NIHR Clinical Research Facility and BRC at Guy’s and St. Thomas’ National Health Service (NHS) Foundation Trust (GSST) and King’s College London (N.H. and B.C.), and by University College London and UCLH BRC (H.E.M., Z.A.P., and A.S.M.). The NIHR doctorate fellowship (2010–2014) underpinned the core patient population study on which this follow-up was built, as did funding from the Batchworth Charitable Trust, Moulton Foundation, and European Society of intensive Care Medicine. Additional funding was received from the Whittington Hospital NHS Trust and the European Society of Intensive Care Medicine

Effect of intermittent or continuous feed on muscle wasting in critical illness: A phase II clinical trial.

BACKGROUND: Acute skeletal muscle wasting in critical illness is associated with excess morbidity and mortality. Continuous feeding may suppress muscle protein synthesis as a result of the muscle-full effect, unlike intermittent feeding which may ameliorate it. RESEARCH QUESTION: Does intermittent enteral feed decrease muscle wasting compared with continuous feed in critically ill patients? STUDY DESIGN AND METHODS: In a Phase II interventional single-blinded randomized controlled trial, 121 mechanically-ventilated adult patients with multi-organ failure were recruited following prospective informed consultee assent. They were randomized to the intervention group (intermittent enteral feeding from six four-hourly feeds per 24 hours, n=62) or control group (standard continuous enteral feeding, n=59). The primary outcome was ten-day loss of rectus femoris muscle cross-sectional area determined by ultrasound. Secondary outcomes included nutritional target achievements, plasma amino acid concentrations, glycaemic control and physical function milestones. RESULTS: Muscle loss was similar between arms (-1.1% (95%CI -6.1, -4.0); p=0.676). More intermittently fed patients received 80% or more of target protein (OR 1.52 (1.16-1.99); p<0.001) and energy (OR 1.59 (1.21-2.08); p=0.001). Plasma branched-chain amino acid concentrations before and after feeds were similar between arms on trial day 1 (71 μM (44-98); p=0.547) and trial day 10 (239 μM (33-444); p=0.178). During the 10-day intervention period the coefficient of variation for glucose concentrations was higher with intermittent feed (17.84 (18.6-20.4) versus continuous feed (12.98 (14.0-15.7); p<0.001). However, days with reported hypoglycaemia and insulin usage were similar in both groups. Safety profiles, gastric intolerance, physical function milestones and discharge destinations did not differ between groups. INTERPRETATION: Intermittent feeding in early critical illness is not shown to preserve muscle mass in this trial despite resulting in a greater achievement of nutritional targets than continuous feeding. However, it is feasible and safe

The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review.

Purpose: Early active mobilisation and rehabilitation in the intensive care unit (ICU) is being used to prevent the long-term functional consequences of critical illness. This review aimed to determine the effect of active mobilisation and rehabilitation in the ICU on mortality, function, mobility, muscle strength, quality of life, days alive and out of hospital to 180 days, ICU and hospital lengths of stay, duration of mechanical ventilation and discharge destination, linking outcomes with the World Health Organization International Classification of Function Framework. Methods: A PRISMA checklist-guided systematic review and meta-analysis of randomised and controlled clinical trials. Results: Fourteen studies of varying quality including a total of 1753 patients were reviewed. Active mobilisation and rehabilitation had no impact on short- or long-term mortality (p > 0.05). Meta-analysis showed that active mobilisation and rehabilitation led to greater muscle strength (body function) at ICU discharge as measured using the Medical Research Council Sum Score (mean difference 8.62 points, 95% confidence interval (CI) 1.39–15.86), greater probability of walking without assistance (activity limitation) at hospital discharge (odds ratio 2.13, 95% CI 1.19–3.83), and more days alive and out of hospital to day 180 (participation restriction) (mean difference 9.69, 95% CI 1.7–17.66). There were no consistent effects on function, quality of life, ICU or hospital length of stay, duration of mechanical ventilation or discharge destination. Conclusion: Active mobilisation and rehabilitation in the ICU has no impact on short- and long-term mortality, but may improve mobility status, muscle strength and days alive and out of hospital to 180 days