Testosterone Replacement Therapy and Cardiovascular Risk: A Review

Recent reports in the scientific and lay press have suggested that testosterone (T) replacement therapy (TRT) is likely to increase cardiovascular (CV) risk. In a final report released in 2015, the Food and Drug Administration (FDA) cautioned that prescribing T products is approved only for men who have low T levels due to primary or secondary hypogonadism resulting from problems within the testis, pituitary, or hypothalamus (e.g., genetic problems or damage from surgery, chemotherapy, or infection). In this report, the FDA emphasized that the benefits and safety of T medications have not been established for the treatment of low T levels due to aging, even if a man's symptoms seem to be related to low T. In this paper, we reviewed the available evidence on the association between TRT and CV risk. In particular, data from randomized controlled studies and information derived from observational and pharmacoepidemiological investigations were scrutinized. The data meta-analyzed here do not support any causal role between TRT and adverse CV events. This is especially true when hypogonadism is properly diagnosed and replacement therapy is correctly performed. Elevated hematocrit represents the most common adverse event related to TRT. Hence, it is important to monitor hematocrit at regular intervals in T-treated subjects in order to avoid potentially serious adverse events

Degree of Hydrolysis Affects the Techno-Functional Properties of Lesser Mealworm Protein Hydrolysates

Protein hydrolysates from lesser mealworm (Alphitobius diaperinus, LM) were obtained by enzymatic hydrolysis with protease from Bacillus licheniformis. A preliminary test performed for five hours of hydrolysis generated an insect protein hydrolysate with 15% of degree of hydrolysis (DH), optimum solubility property and oil holding capacity, but emulsifying and foaming ability were completely impaired. In order to investigate the potential implication of DH on techno-functional properties, a set of protein hydrolysates with a different DH was obtained by sub-sampling at different time points during three hours of enzymatic hydrolysis process. An increase in DH% had positive effects on the solubility property and oil holding ability, while a reduced emulsifying ability was observed up to five hours of hydrolysis. These results demonstrated that the enzymatic hydrolysis, if performed under controlled conditions and not for a long period, represents a valid method to extract high quality protein from insects with tailored techno-functionality, in order to produce tailored ingredients for feed and food purpose

DECELERATION COUNTS: ESTIMATING THE ENERGY COST OF SHUlTLE RUNNING FROM MECHANICAL WORK

To estimate the energetic requirements of 5-m shuttle running based on kinematic data, we devised a modified version of existing models for the estimation of the energy cost of gait. In our approach, negative/eccentric work during deceleration phases was added to positive/concentric work in propulsive phases. Ten subjects performed two 5-rnin trials at 50% and 75% of their maximal aerobic speed. The metabolic cost estimated from 30 kinematics was compared to that measured by a portable metabolimeter. The estimation error was 1.2 J/kg/s (7.3%): results encourage to apply this method for the estimation of the workload in sports involving frequent turns and changes of direction

Effectiveness of enzymatic hydrolysis for reducing the allergenic potential of legume by-products

The interest in agri-food residues and their valorization has grown considerably, and many of them are today considered to be valuable, under-exploited sources of different compounds and notably proteins. Despite the beneficial properties of legumes by-products, there are also some emerging risks to consider, including their potential allergenicity. In this work the immunoreactivity of chickpea, pea, and white bean by-products was assessed, and whether the production of enzymatic hydrolysates can be an effective strategy to reduce this allergenic potential. The results presented clearly indicate that the efficiency of this strategy is strongly related to the enzyme used and the food matrix. All legume by-products showed immunoreactivity towards serum of legume-allergic patients. Hydrolysates from alcalase did not show residual immunoreactivity for chickpea and green pea, whereas hydrolysates from papain still presented some immunoreactivity. However, for white beans, the presence of antinutritional factors prevented a complete hydrolysis, yielding a residual immunoreactivity even after enzymatic hydrolysis with alcalase

Testosterone and Sexual function.

There is much evidence documenting that testosterone (T) plays a crucial role in regulating male sexual function acting at either the central or peripheral levels. Sexual symptoms, and in particular erectile dysfunction and reduced frequency of sexual thoughts and sleep-related erections represent the most specific symptoms associated with hypogonadism in adulthood. There is evidence to suggest that sex is actually an excellent way to boost T levels in milder forms of hypogonadism. It has been reported that sexual inertia resets the reproductive axis to a lower activity, somehow inducing a secondary hypogonadism, characterized by a reduced Luteinizing Homrone (LH) bioactivity. T replacement therapy is capable of improving all aspects of male sexual function and should be considered the first line treatment in patients with erectile dysfunction with overt hypogonadism. However, TTh as mono-therapy might not be sufficient in complicated subjects. In such cases, combination therapy with phosphodiesterase type V inhibitors may improve the outcome. In young uncomplicated individuals with milder forms of hypogonadism, the restoration of normal sexual function, however obtained, might improve T levels

3D comparison of dental arch stability in patients with and without cleft lip and palate after orthodontic/rehabilitative treatment

This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches

Evaluation by 3D stereophotogrammetry of facial changes in edentulous patients after rehabilitation

To assess facial changes after oral rehabilitation with complete dentures (CDs) by 3D technology allows understanding the results of a treatment that changes facial proportions. Precise outcome parameters can improve decision making. Objective: This descriptive observational research aimed to assess facial changes in completely edentulous patients after oral rehabilitation with a CD by a 3D stereophotogrammetry system. Methodology: 30 edentulous patients (7 men and 23 women), aged 50 to 75, were analyzed with stereophotogrammetry at 28 previously determined anthropometric landmarks, at 2 different times: T1, before treatment, and T2, after inserting the CDs. Images were analyzed with a specific software for linear and angular measurements. The paired t-test was used to compare timestamps (α=0.05). Results: Major changes were observed in 7 of the 13 linear measures and 7 of the 9 angular measures. The following linear measurements had an increase: Sn-Gn (lower third of the face), Ls-Li (height of the vermilion lip), and ChL-ChR (mouth width). Sn-Ls (nasal philtrum height) decreased. For angular measurements, Sn-St-Pg (lower facial convexity) angles increased, and the Prn-Sn-Ls (nasolabial angle) and GoR-Pg-GoL (mandible convexity) angles decreased. Conclusions: Major facial changes in newly rehabilitated edentulous patients with CDs included an increase of the lower third of the face, of the vermilion lip, of mouth width, and of the lower facial convexity, and a decrease of the nasolabial angle and mandible convexity

Assessment of facial asymmetry using stereophotogrammetry

Asymmetry in the dimensions and spatial position of facial structures is a common finding in healthy individuals and in esthetically pleasing faces (1). Additionally, a variety of craniofacial anomalies are characterized by severe hard- and soft-tissue asymmetry (2). Facial asymmetry can impair the affected people from both aesthetical and functional points of view. Currently, facial asymmetry is mainly evaluated using the entire facial surface, thus providing measurements that give only general information about facial morphology. In contrast, several pathologies affecting facial appearance are localized in selected parts of the face, and a local assessment can provide helpful information for clinical decisions. For these reasons a detailed, focused and objective evaluation of facial asymmetry is advised, both for surgical planning and treatment evaluation. In this study we present a new quantitative method to assess symmetry in different facial thirds, objectively defined on the territories of distribution of trigeminal branches. Forty healthy young adults (21 women; 19 men; average age 39 ± 12 years) were acquired with a stereophotogrammetric system and the level of asymmetry of their hemi-facial thirds was evaluated, comparing the root mean square of the distances (RMSD) between their original and mirrored facial surfaces. The method resulted highly reproducible (Bland and Altman coefficient of reproducibility for area selection, 98.8%). In the upper facial third, median asymmetry was 0.726 mm (IQ range: 0.579-0.954 mm); in the middle facial third, median asymmetry was 0.739 mm (IQ range: 0.558-0.887 mm); in the lower facial third, median asymmetry was 0.679 mm (IQ range: 0.552-0.907 mm). No significant differences in RMSD values among the facial thirds were found (ANOVA, p>0.05). The presented method provides an accurate, reproducible and local facial symmetry analysis, that can be used for different conditions, especially when only part of the face is asymmetric.This work was supported by grants from University of Milan (Grant for Research 2015-2017)