Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

The Biochemical and Pathological Correlates of Successful Semen Cryopreservation From Patients With Testicular Cancer: A Single Tertiary Center Experience

OBJECTIVE To determine the predictors for success with regard to semen cryopreservation and good semen quality of patients with testicular cancer. ;MATERIALS AND METHODS A total of 50 men (aged 16-36 years) with testicular cancer, referred for semen cryopreservation prior to gonadotoxic treatment, were included. Age, alpha fetal protein (alpha-FP), beta human chorionic gonadotropin, lactate dehydrogenase, clinical staging, tumor volume, and pathological reports were evaluated as correlates of successful semen cryopreservation and good semen quality. ;RESULTS The overall success rate was 52%. alpha-FP (4113.1 ng/mL vs 81.2 ng/mL) and tumor volume (77.7 mL vs 25.5 mL) were significantly higher in the failure group as compared to the success group. The seminoma to nonseminomatous germ cell tumor ratio was lower in the failure group as compared to the success group (9/17 vs 3/21). There was nearly a significant difference (P = .066). The optimal cutoff value for alpha-FP > 1000 ng/mL showed the highest Youden index (0.689) and resulted in a sensitivity of 0.625 and specificity of 1.0 for predicting poor outcome. In terms of multivariate analysis, the alpha-FP (P = .013), tumor volume (P = .047), and alpha-FP > 1000 ng/mL (P = .010) were significantly associated with poor semen quality and failure to preserve semen. Sperm quality was found to be higher in the seminoma versus the nonseminomatous germ cell tumor patients in: sperm concentration (21.5 million/mL vs 11.8 million/mL, P < .027). Furthermore, tumor volume is correlated to alpha-FP (P = .018) and is weakly correlated to lactate dehydrogenase (P = .067) ;CONCLUSION Elevated alpha-FP and tumor volume are independently poor factors for semen quality and semen cryopreservation. In clinical use, alpha-FP is a noninvasive tool to predict the success of semen cryopreservation and patients with alpha-FP > 1000 ng/mL should be informed of the higher risk of poor semen quality and semen cryopreservation concerns. (C) 2016 Elsevier Inc

Temporal Trend of Newly Diagnosed Incidence, Medical Utilization, and Costs for Pediatric Urolithiasis, 1998-2007: A Nationwide Population-based Study in Taiwan

OBJECTIVE To investigate the trends of newly diagnosed incidence, medical utilization, and medical costs for pediatric urolithiasis in Taiwan. ;MATERIALS AND METHODS The present study uses the National Health Insurance Research Database, which contains the data of all medical benefit claims from the individuals enrolled in the national and single-payer insurance program in Taiwan. The National Health Insurance covered 22,717,053 enrollees, nearly 99% of Taiwan's population. Our analysis includes all subjects aged <18 years with a primary diagnosis of urolithiasis. We analyzed the temporal trend for annual newly diagnosed incidence, medical care visits, and medical costs for pediatric urolithiasis from 1998 to 2007. ;RESULTS A total of 1474 patients aged <18 years with newly diagnosed urolithiasis were identified, including 719 (48.8%) boys and 755 (51.2%) girls. The overall newly diagnosed rate of urolithiasis in pediatric population was 0.038% in 2007. The peak age stratum of urolithiasis occurrence in 2007 was 15-18 years. The trend of annual newly diagnosed incidences for boys, girls, and all children declined from 1998 to 2007. Furthermore, there were declining trends both in medical costs and annual medical care visits during the study period. ;CONCLUSION This is the first nationwide population-based study to indicate the declining trends in newly diagnosed rate, medical care visits, and medical costs for pediatric urolithiasis. These findings help to quantify and establish the burden of pediatric urolithiasis. These findings help to quantify and establish the burden of medical care for pediatric urolithiasis and to further refine the medical policy. (C) 2015 Elsevier Inc

Pelvic hematoma following transrectal ultrasound-guided prostate needle biopsy: A case report and literature review

Transrectal ultrasound-guided prostate (TRUS-P) needle biopsy is a common procedure for detection of prostate cancer. Complications associated with TRUS-P biopsy are almost always minor and do not require hospitalization. Pelvic hematoma following TRUS-P biopsy is an extremely rare complication. Only a few cases have been reported in the past. Here we report the case of a 67-year-old man diagnosed with pelvic hematoma following TRUS-P biopsy who presented with tenderness in the lower abdomen and ecchymosis in the paraumbilical region, lower abdomen, and scrotum. To our knowledge, no other case has been reported in Taiwan. Therefore, we discuss this case report and review the literature associated with complication of TRUS-P biopsies

Application of a Deep Learning Neural Network for Voiding Dysfunction Diagnosis Using a Vibration Sensor

In a clinical context, there are increasing numbers of people with voiding dysfunction. To date, the methods of monitoring the voiding status of patients have included voiding diary records at home or urodynamic examinations at hospitals. The former is less objective and often contains missing data, while the latter lacks frequent measurements and is an invasive procedure. In light of these shortcomings, this study developed an innovative and contact-free technique that assists in clinical voiding dysfunction monitoring and diagnosis. Vibration signals during urination were first detected using an accelerometer and then converted into the mel-frequency cepstrum coefficient (MFCC). Lastly, an artificial intelligence model combined with uniform manifold approximation and projection (UMAP) dimensionality reduction was used to analyze and predict six common patterns of uroflowmetry to assist in diagnosing voiding dysfunction. The model was applied to the voiding database, which included data from 76 males aged 30 to 80 who required uroflowmetry for voiding symptoms. The resulting system accuracy (precision, recall, and f1-score) was around 98% for both the weighted average and macro average. This low-cost system is suitable for at-home urinary monitoring and facilitates the long-term uroflow monitoring of patients outside hospital checkups. From a disease treatment and monitoring perspective, this article also reviews other studies and applications of artificial intelligence-based methods for voiding dysfunction monitoring, thus providing helpful diagnostic information for physicians

Acute manic and psychotic symptoms following subcutaneous leuprolide acetate in a male patient without prior psychiatric history: A case report and literature review

Leuprolide acetate is usually used in the treatment of advanced prostate cancer. The adverse events associated with administration of leuprolide acetate include fatigue, hot flashes, loss of libido, impotence, and depression. These side effects can be treated conservatively. Acute manic and psychiatric symptoms following leuprolide acetate injection are very rare. Few case reports have been published documenting these symptoms. Here, we describe the case of a 62-year-old male with metastatic prostate cancer, who developed acute manic and psychiatric symptoms 2 months after subcutaneous leuprolide acetate injection. These symptoms were relieved after administration of neuroleptic drugs, such as risperidone. Administration of leuprolide acetate was eventually stopped. The exact mechanism causing the manic and psychiatric adverse events is unclear. Some experts have theorized that estrogen withdrawal following leuprolide acetate therapy may induce psychiatric symptoms. Manic episodes may arise from a deficit in central serotonergic neurotransmission. Based on these hypotheses, risperidone, lithium, and some anticonvulsants, such as divalproex sodium and carbamazepine, have been used effectively in the treatment and prophylaxis of manic episodes. Although psychiatric adverse events are rare following administration of leuprolide acetate, clinicians should be aware of the possibility

Factors associated with reoperation in hypospadias surgery — A nationwide, population-based study

To analyze the preoperative factors associated with the need for secondary surgery following primary urethroplasty. This study utilized a subset of the National Health Insurance Research Database, which includes the data on all paid medical benefit claims from 1997 to 2007, for 1 million beneficiaries in 2005. We analyzed the claims data for all patients with hypospadias who had undergone primary urethroplasty. The characteristics of the patients, surgeons, and hospitals associated with surgical outcomes were analyzed to investigate possible associations with the need for secondary surgery. Among 52, 705 live male newborn babies, 218 were diagnosed with hypospadias, of whom 89 received repair surgery. A total of 75 (84.3%) male newborn babies received single hypospadias surgery, and 14 (15.7%) underwent more than two surgical procedures. Univariate analysis demonstrated that the type of hypospadias and the surgeon caseload volume were significantly associated with the need for additional hypospadias surgery (p = 0.02 and p = 0.03, respectively). In multivariate analysis, the type of hypospadias (distal vs. proximal, odds ratio, 0.25, p = 0.03) and the surgeon caseload volume (high vs. low, odds ratio, 0.04, p = 0.05) were significantly correlated with secondary operation. The type of hypospadias and the surgeon caseload volume were significantly associated with the need for secondary hypospadias surgery. The findings of this study provide important information on the outcomes of hypospadias repair for parents and specialists