Abusive use of anabolic androgenic steroids, male sexual dysfunction and infertility: an updated review

The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual’s health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often reported in the literature, but little is known regarding its actual prevalence, possible underpinning mechanisms, and potential treatments either during or post-AAS usage. Thus, the current narrative review summarizes the state-of-art regarding the effects of AAS on male fertility and sexual function. Evidence was gathered from the latest reviews and recent original studies, specifically from prospective cohorts and clinical trials, ultimately resulting in five main topics of discussion. First, AAS usage is briefly characterized by its historical background, main physiological mechanisms, and the most frequently used AAS substances. Second, data on the prevalence of AAS-induced male infertility and sexual dysfunction are described. Third, some new insights on possible underpinning mechanisms of AAS-induced male infertility and sexual dysfunction are thoroughly discussed, with particular attention to histological data derived from animal models and the latest insights from prospective cohorts in humans. Fourth, the potential treatments during and after the AAS usage are presented, highlighting the odds of resolving male infertility and sexual dysfunction. Fifth, future directions on this topic are discussed, focusing on the methodological robustness of scientific studies

MASSIVE INFESTATION BY Ascaris lumbricoides: CASE REPORT

A ascaridíase é endêmica em países em desenvolvimento e está relacionada a baixas condições socioeconômicas. É a helmintíase mais prevalente, principalmente nos pacientes pediátricos, sendo assintomática na maioria dos casos. Na infestação maciça, pode evoluir com complicações tais como obstrução intestinal e invasão das vias biliares. Radiografia abdominal e ultrassonografia são os principais exames médicos diagnósticos. Inicialmente o tratamento é conservador, no entanto pode se tornar cirúrgico. O objetivo desse trabalho é analisar a apresentação clínica, o diagnóstico e o tratamento de infestação maciça por Ascaris lumbricoides através do relato de um caso de ascaridíase maciça em criança de Macapá – AP, que evoluiu com suboclusão intestinal e invasão da vesícula e das vias biliares. Os dados foram coletados do prontuário médico e foi feita revisão da literatura nos principais acervos médicos digitais no período de 2000 a 2014. Uma vez conhecendo suas formas de apresentação e complicações, os médicos estarão aptos a manejá-la apropriadamente, contribuindo para diminuir sua morbimortalidade nas regiões endêmicas.Palavras-chave: Ascaridíase maciça, migração errática, suboclusão intestinal, invasão das vias biliares, invasão da vesícula biliar.Ascariasis is endemic in developing countries and it is related to substandard socioeconomic conditions. It is the most prevalent helminthiasis, especially in pediatric patients, being asymptomatic in most cases. In massive infestation, it can develop complications such as intestinal obstruction and invasion of the biliary tract. Abdominal radiography and ultrassonography are the main medical tests for diagnosis. Initially treatment is conservative but it can change into surgery. The aim of this paper is to analyze clinical presentation, diagnosis and treatment of massive infestation by Ascaris lumbricoides through the report of a case of massive ascariasis in a child from Macapá – AP, that developed into intestinal subocclusion and invasion of the biliary tree and gallbladder. Data was collected from the medical records and it was made a review of the literature in the main medical database available on digital pile on the period of 2000 to 2014. Once they know its forms of presentation and complications, doctors will be able to appropriately manage it, contributing to diminishing its morbimortality in endemic regionsKeywords: Massive ascariasis; Erratic migration; Intestinal subcclusion; Invasion of the biliary tract; Invasion of gallbladde

Habits and lifestyles studied as risk factors for testicular function in male infertility

Esta pesquisa objetiva analisar as influências dos hábitos e do estilo de vida (tabagismo, consumo habitual de bebidas alcoólicas, uso de maconha e sedentarismo) na função testicular de homens inférteis atendidos em clínica de Andrologia. Foi realizado estudo retrospectivo, quantitativo, com análise de dados de prontuários de 280 homens inférteis com idade de 18 a 59 anos, e que realizaram análise seminal completa, dosagem sérica de testosterona total e aferição de volume testicular (orquidômetro, paquímetro ou ultrassonografia). Foram excluídos casos de infertilidade ligada a doenças genéticas, infecção nos órgãos reprodutivos e disgenesia gonadal. Os exames incluídos foram a análise seminal completa, atividade hormonal, marcadores bioquímicos e testes de função espermática (atividade da enzima intracelular creatina kinase, anticorpos antiespermatozoides, radicais livres de oxigênio e teste de fragmentação de DNA espermático). Regressão logística multifatorial foi realizada para determinar os efeitos do tabagismo, consumo de bebida alcoólica, uso regular de maconha >= 12 meses e sedentarismo em cada um dos exames incluídos no estudo. Análise estatística foi realizada usando o software Statistical Package for the Social Sciences (SPSS®) 23.0 (p = 10 anosmaço está associado com menores concentrações de prolactina (P = 0,03; B = -2,40) e glicemia de jejum (P = 0,04; B = -5,40), enquanto o consumo habitual de bebidas alcoólicas em dose >= 37,2 mL/dia relaciona-se com menores níveis de VLDL (P = 0,03; B = -3,72). O sedentarismo se relaciona a maiores concentrações de prolactina (P = 0,03; B = 1,28) e ferritina séricas (P = 0,02; B = 63,87). Dos hábitos estudados, o consumo regular de maconha por mais de 12 meses provocou efeitos hormonais deletérios à função testicular de homens inférteis.This study investigates the influence of habits and lifestyle (cigarette smoking, regular consumption of alcohol, marijuana use, and sedentary lifestyle) correlated with the testicular function of infertile men attending an Andrology set up. A retrospective quantitative study was performed with data analysis from medical records of 280 infertile men aged 18 to 59 years old who performed a complete seminal analysis, serum total testosterone, and testicular volume measurement (orchidometer, pachymeter, or ultrasound). Individuals with infertility caused by genetic diseases, infections in reproductive organs, and testicular dysgenesis were excluded. A complete seminal analysis, hormonal levels, serum biochemical markers, and sperm functional tests (creatine-kinase, anti-sperm antibodies, reactive oxygen species, and sperm DNA fragmentation test) were applied. Multiple linear regression analysis was performed to investigate the effects of cigarette smoking, regular consumption of alcohol, regular use of marijuana >= 12 months, and sedentary lifestyle on each variable. Statistical analysis was conducted using SPSS® 23.0 (p < 0.05). No direct effect of any habit or lifestyle substantially modified any seminal parameters, testosterone concentration, or testicular volume in an already infertile population. Marijuana was associated with lower serum estradiol levels (P < 0.001; B = -11.61), higher prolactin (P < 0.001; B = 3.21) and SHBG concentration (P = 0.02; B = 7.49), in addition to higher values of T/E2 ratio (P = 0.004; B = 14.03)

Quality of sexual life in adult and elderly female college students from a university in amazon

INTRODUCTION: Female sexual function arises from a complex interaction of biological, psychological, and social factors. Few Brazilian studies have addressed sexuality in the elderly population — 10-20% of individuals are sexually active. OBJECTIVES: To compare the overall quality of sexual life and its domains in adult and elderly female college students. METHODS: Female students from the University of Amapá, Brazil, were enrolled in this cross-sectional study. The Female Sexual Quotient (FSQ) questionnaire was used to assess various components of quality of sexual life in adult (34-59 years old) and elderly (60-79 years old) students. The study was approved by the institutional review board. RESULTS: A total of 123, of which 49.6% were married, participated in this study. Mean FSQ score for the elderly group was (n=66) 61.5, classified as “average” and for the adult group 71.6, classified as “partially satisfied” (p &lt; 0.01). Statistically significant differences between adults and elderly groups were also observed for two FSQ domains: “foreplay quality” (p &lt; 0.001), and “objective arousal and harmony with the partner” betters in the adults group (p &lt; 0.05). CONCLUSION: In this sample, elderly college student showed worst FSQ scores when compared to the adult ones at the same university. Compared to adult women, the quality of sexual life varies more in elderly, probably reflecting age-related morbidities as well as their partners' health. Adult women report foreplay quality being a strong motivation to continue having sex. In the elderly students, sexual arousal is mainly affected by a lack of vaginal lubrication, which is explained primarily by menopause.</p

A Case with Pachyonychia Congenita and B-cell Lymphoma

Pachyonychia congenital (PC) is a rare autosomal dominant genodermatosis characterized hyperkeratosis affecting the nails and palmoplantar areas, oral leukokeratosis, and cystic lesions. A 39-year-old woman with PC type 1 (Jadassohn-Lewandowsky syndrome) and B-cell lymphoma is described. No similar disorders or parental consanguinity were found in her family. Typical features of PC developed since her early childhood and the diagnosis of B-cell lymphoma was established seven years ago, without a clear causal relation between these entities. Despite inherent limitations of a single case, this report may contribute to PC understanding

Antigen-Specific Antibody Signature Is Associated with COVID-19 Outcome

Numerous studies have focused on inflammation-related markers to understand COVID-19. In this study, we performed a comparative analysis of spike (S) and nucleocapsid (N) protein-specific IgA, total IgG and IgG subclass response in COVID-19 patients and compared this to their disease outcome. We observed that the SARS-CoV-2 infection elicits a robust IgA and IgG response against the N-terminal (N1) and C-terminal (N3) region of the N protein, whereas we failed to detect IgA antibodies and observed a weak IgG response against the disordered linker region (N2) in COVID-19 patients. N and S protein-specific IgG1, IgG2 and IgG3 response was significantly elevated in hospitalized patients with severe disease compared to outpatients with non-severe disease. IgA and total IgG antibody reactivity gradually increased after the first week of symptoms. Magnitude of RBD-ACE2 blocking antibodies identified in a competitive assay and neutralizing antibodies detected by PRNT assay correlated with disease severity. Generally, the IgA and total IgG response between the discharged and deceased COVID-19 patients was similar. However, significant differences in the ratio of IgG subclass antibodies were observed between discharged and deceased patients, especially towards the disordered linker region of the N protein. Overall, SARS-CoV-2 infection is linked to an elevated blood antibody response in severe patients compared to non-severe patients. Monitoring of antigen-specific serological response could be an important tool to accompany disease progression and improve outcomes

Impact of Retirements and Pensions on the Social Welfare of the Households from Minas Gerais State

One of the main arguments for the existence of public social security systems relates to their potential use as income distribution and welfare policy tools. In this vein, several studies have sought to evaluate the effects of social security benefits on poverty and inequality. However, the evidence obtained from Brazilian studies regarding the effects of social security remains inconclusive, and studies evaluating the impact of social security on social welfare indices are scarce. The objective of this paper is to measure the impact of retirement and pensions provided by social security programs on the welfare level of households in the state of Minas Gerais, Brazil. The methodological approach is based on propensity score matching, and microdata from the National Household Sample Survey (Pesquisa Nacional por Amostra de Domicílios - PNAD, 2009) are used. The results demonstrate that income from retirement and pensions represents an important portion of beneficiary households' income, especially lower-income beneficiary households. The results suggest that social security has a positive effect on the incomes, access to knowledge and living conditions of the households analyzed. The impact of retirement and pensions on households in low-income groups (Classes D and E) tends to be more significant relative to the impact on middle class households (Class C)