Serum Dioxin, Testosterone, and Subsequent Risk of Benign Prostatic Hyperplasia: A Prospective Cohort Study of Air Force Veterans

BACKGROUND: Operation Ranch Hand veterans were involved in spraying herbicides, including Agent Orange, during the Vietnam War in 1962–1971; Agent Orange was contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). It has been hypothesized that dioxins may be partially responsible for an increase of male reproductive tract disorders such as testicular cancer, cryptorchidism, and hypospadias. OBJECTIVES: In this study, our objective was to assess the effect of serum TCDD concentration on the risk of development of benign prostatic hyperplasia (BPH) and on serum testosterone levels. METHODS: This study was a longitudinal, prospective cohort study made up of U.S. Air Force veterans involved in Operation Ranch Hand. Other Air Force veterans who did not spray herbicides were included as comparisons. BPH was determined by medical record review and by medical examinations conducted during the study. Data were available for 971 Ranch Hand and 1,266 comparison veterans. We investigated the relationship between BPH and serum TCDD level using the Cox proportional hazards models adjusted for testosterone levels, body mass index (BMI), and the percentage change in BMI per year. RESULTS: In univariate and multivariate analyses, the risk of BPH decreased with increasing serum TCDD in the comparison group. The multivariate risk ratio for BPH in the comparison group was 0.84 (95% confidence interval, 0.73–0.98). Excluding men with prostate cancer, inflammatory or other prostatic diseases did not substantially alter the association. Serum testosterone levels were inversely associated with serum TCDD levels in both Ranch Hand and comparison groups. CONCLUSIONS: TCDD exposure at general population levels is associated with a decreasing risk of BPH with higher exposure levels. TCDD exposure is also negatively associated with serum testosterone levels

The effects of stochastic resonance electrical stimulation and neoprene sleeve on knee proprioception

<p>Abstract</p> <p>Background</p> <p>A variety of knee injuries and pathologies may cause a deficit in knee proprioception which may increase the risk of reinjury or the progression of disease. Stochastic resonance stimulation is a new therapy which has potential benefits for improving proprioceptive function. The objective of this study was to determine if stochastic resonance (SR) stimulation applied with a neoprene sleeve could improve knee proprioception relative to a no-stimulation/no-sleeve condition (control) or a sleeve alone condition in the normal, healthy knee. We hypothesized that SR stimulation when applied with a sleeve would enhance proprioception relative to the control and sleeve alone conditions.</p> <p>Methods</p> <p>Using a cross-over within subject design, twenty-four healthy subjects were tested under four combinations of conditions: electrical stimulation/sleeve, no stimulation/sleeve, no stimulation/no sleeve, and stimulation/no sleeve. Joint position sense (proprioception) was measured as the absolute mean difference between a target knee joint angle and the knee angle reproduced by the subject. Testing was conducted during both partial-weight bearing (PWB) and non-weight bearing (NWB) tasks. Differences in joint position sense between the conditions were evaluated by repeated-measures analysis of variance testing.</p> <p>Results</p> <p>Joint position sense error during the stimulation/sleeve condition (2.48° ± 1.32°) was found to be more accurate (P < 0.05) relative to the control condition (3.35° ± 1.63°) in the PWB task. No difference in joint position sense error was found between stimulation/sleeve and sleeve alone conditions for the PWB task. Joint position sense error was not found to differ between any of the conditions for the NWB task.</p> <p>Conclusion</p> <p>These results suggest that SR electrical stimulation when combined with a neoprene sleeve is an effective modality for enhancement of joint proprioception in the PWB knee. We believe these results suggest the need for further study of the potential of SR stimulation to correct proprioceptive deficits in a clinical population with knee injury/pathology or in subjects at risk of injury because of a proprioceptive deficit.</p

A randomized study on migration of the Spectron EF and the Charnley flanged 40 cemented femoral components using radiostereometric analysis at 2 years

Background and purpose: We performed a randomized study to determine the migration patterns of the Spectron EF femoral stem and to compare them with those of the Charnley stem, which is regarded by many as the gold standard for comparison of implants due to its extensive documentation. Patients and methods: 150 patients with a mean age of 70 years were randomized, single-blinded, to receive either a cemented Charnley flanged 40 monoblock, stainless steel, vaquasheen surface femoral stem with a 22.2-mm head (n = 30) or a cemented Spectron EF modular, matte, straight, collared, cobalt-chrome femoral stem with a 28-mm femoral head and a roughened proximal third of the stem (n = 120). The patients were followed with repeated radiostereometric analysis for 2 years to assess migration. Results: At 2 years, stem retroversion was 2.3° and 0.7° (p < 0.001) and posterior translation was 0.44 mm and 0.17 mm (p = 0.002) for the Charnley group (n = 26) and the Spectron EF group (n = 74), respectively. Subsidence was 0.26 mm for the Charnley and 0.20 mm for the Spectron EF (p = 0.5). Interpretation: The Spectron EF femoral stem was more stable than the Charnley flanged 40 stem in our study when evaluated at 2 years. In a report from the Norwegian arthroplasty register, the Spectron EF stem had a higher revision rate due to aseptic loosening beyond 5 years than the Charnley. Initial stability is not invariably related to good long-term results. Our results emphasize the importance of prospective long-term follow-up of prosthetic implants in clinical trials and national registries and a stepwise introduction of implants