1,721,088 research outputs found
Disfunzioni sessuali contemporanee: la sessualità nei giovani adulti
No full textNegli adolescenti e nei giovani adulti, la salute sessuale e riproduttiva è un bene prezioso, da tutelare e proteggere; tuttavia, sin troppo spesso la letteratura scientifica trascura questa importante fase della vita. Scopo di questa rassegna è discutere delle principali problematiche della sessualità dei giovani, identificando i fattori di rischio, approfondendo il ruolo di Internet e le possibili ricadute sulla salute sessuale
“Segmental testicular ischaemia: presentation, managment and follow-up”
Full text linkSegmental infarction of the testis is a rare event. Less than 40 cases have been reported in the literature and its aetiology remains largely unknown. The diagnosis is challenging and its identification crucial as partial ischaemia is frequently confused with testicular tumours and unnecessarily treated with orchiectomy. The objectives of this study are to: (i) raise awareness of this rare condition, (ii) provide the distinctive clinical and radiological features enabling pre-operative diagnosis, (iii) promote appropriate screening of causative factors and (iv) propose an alternative management approach to avoid surgery and preserve fertility. We describe three cases of partial testicular ischaemia in men presenting with reduced sperm quality. The cases demonstrate the ultrasound and magnetic resonance imaging appearance of testicular ischaemia. The surveillance strategy adopted for these lesions indicates that over 2 years of follow-up, marginal changes in the lesions can occur. Histology revealed that infiltration by stromal cells, leucocytes and macrophages is responsible for the remodelling of these lesions. Screening of risk factors for thromboembolism revealed that all patients carried a methylenetetrahydrofolate reductase 677C-->T (MTHFR) mutation in a gene involved in folate metabolism, and either borderline or elevated homocysteine levels. Distinctive features permit the pre-operative diagnosis of segmental testicular ischaemia. There are sufficient data to assert that a surveillance strategy is safe and feasible. We speculate that the defects in folate metabolism may pre-dispose individuals to the development of testicular infarction and infertility
Stili di vita e prevenzione della malattie cronico-degenerative
No full textAlla base della maggior parte delle patologie croniche, quali le malattie cardiovascolari, i tumori ed il diabete, ci sono fattori di rischio intermedi ormai ben noti rappresentati da obesità, dislipidemia, iperglicemia e ipertensione, responsabili della maggior parte dei decessi soprattutto nei paesi industrializzati. La presenza di questi fattori di rischio intermedi si può spesso ricondurre a quattro stili di vita non corretti in termini di salute, quali l’abitudine al fumo di tabacco, un’alimentazione non sana, la sedentarietà e l’abuso di alcolici. Per questo agire in modo coordinato e integrato sui principali fattori di rischio modificabili diventa una priorità non solo dei programmi sanitari, ma anche di ogni medico, per migliorare la salute, la qualità della vita e il benessere del singolo e della società in generale
Medical treatment to improve sperm quality
No full textApproximately 30% of cases of couple infertility are due to a malefactor. Several conditions can interfere with spermatogenesis and reduce sperm quality and production. Treatable conditions, such as hypogonadism, varicocele, infections and obstructions, should be diagnosed and corrected, but many aspects of male factor infertility remain unclear. Various agents have been used in the attempt to increase the fertility potential of subjects with idiopathic oligoteratoasthenozoospermia. The rationale of medical treatment to improve sperm quality in these subjects has been questioned by the introduction of assisted reproductive technologies. However, there is now growing awareness of the importance of good quality spermatozoa for embryonic development and higher birth rates. Confounding factors in assessing the efficacy of male infertility treatments have erroneously inflated the superiority of assisted reproductive technologies over conventional approaches. A systematic review is given of relevant randomized controlled trials and effects on semen parameters. The analysis reveals that although results are heterogeneous, gonadotrophins, anti-oestrogens, carnitine and trace elements may be beneficial in improving sperm quality, although their effect on pregnancy rate remains controversial. The most common drug regimens are compared and an estimate of the results expected from these treatments provided
Endocrine evaluation of erectile dysfunction
No full textErectile dysfunction is highly prevalent, affecting up to half of men in their 50-70s, and has been variably associated to a variety of causes including unhealthy lifestyles, such as smoking or overweight, or comorbidities such as hypertension, diabetes mellitus, and neurological disorders. General interest toward ED has exploded since the introduction of phosphodiesterase type 5 inhibitors-oral drugs that are widely accepted as the first line treatment in patients suffering from this conditions. In the last decade, the time lapse between first symptoms of sexual disorders and seeking of medical advice has greatly reduced. Unfortunately, none of the PDE5i has been proven curative, but rather acts as a symptomatic treatment. The availability of very active and safe drugs, however, diminished the space for diagnosis and search of etiological treatments. This is particularly true for the several endocrinopathies associated with ED. A number of epidemiological data support an inverse relationship between sexual health and testosterone levels, and it is well accepted that testosterone deficiency is a good marker of sexual and physical frailty. However, several other hormones, including LH, prolactin, TSH, and FT4 are involved in sexual functioning and should be investigated in a proper work-out of ED. Existing guidelines provide information almost entirely focusing on late-onset hypogonadism and therapeutic strategies; this mini-review aims to provide a wider spectrum of the diagnostic endocrine work-out of ED patients unrevealing the complexity of conditions, overt or subclinical, which can affect ED
Subclinical male hypogonadism
No full textMale hypogonadism is traditionally defined as the inadequate production of testosterone and impaired spermatozoa generation in the presence of elevated or reduced levels of gonadotropins. A more frequent measurement of testosterone levels and the development of highly sensitive and specific assays have led to the detection of less clinically evident gonadal dysfunction, in which small biochemical alterations may or may not be accompanied by signs and symptoms. This condition is called "compensated" or "subclinical" hypogonadism. To determine whether subclinical hypogonadism is a paraphysiological state, a clinical condition in itself, or a precursor to overt hypogonadism, we carried out a literature review with the aim of establishing a practical approach to subclinical hypogonadism. (C) 2012 Elsevier Ltd. All rights reserved
Strategies and advantages of early diagnosis in Klinefelter's syndrome
No full textNearly 70 years after its description, Klinefelter's syndrome (KS) remains a largely undiagnosed condition. In addition to its typical characteristics of increased follicle-stimulating hormone secretion and small and firm testes, the syndrome presents an extremely wide spectrum of phenotypes. This could be explained by the possible presence of chromosomal mosaicism, androgen receptor polymorphisms and related heterogeneous endocrine abnormalities. The varied but relatively mild physical abnormalities also explain why many patients do not receive clinical attention until adulthood, when they seek medical advice on small testes or infertility. Diagnosis is also hindered by the low awareness of the disease among health professionals. This paper aims to review the possible signs of KS at different stages of life that could help achieve an early (or at least earlier) diagnosis. It has been demonstrated that the early diagnosis of KS improves patients' quality of life and enables better medical treatment. To achieve this, it is crucial to increase both medical and general awareness of the disease, includingthrough use of the media and patients' associations. © The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology
The Woman's Heart: Insights into New Potential Targeted Therapy
No full textCardiovascular disease is an increasingly common cause of death in women. There is as yet no consensus on the analysis of cardiovascular risk factors with regard to the specific, personalised treatment of pre- and post-menopausal women. Clinically significant cardioprotective and antiremodelling effects have been observed in animal and human studies exploring chronic inhibition of phosphodiesterase type 5 (PDE5). The relationship between the heart, estrogens and PDE5 inhibitors (PDE5is) remains unclear. Experimental data suggest potential beneficial effects on cardiac geometry, function, endothelial function and microvascular coronary flow in women. It was recently postulated that the efficacy of PDE5is is estrogen-dependent in female heart disease. A registered randomised, placebo-controlled study, RECOGITO (NCT01803828), aimed at identifying the genderspecific efficacy of long-term PDE5 inhibition in diabetic cardiomyopathy, is currently recruiting patients. Estrogen receptor modulation could be a new promising approach to heart protection via PDE5is. PDE5is could be indicated as a gender-oriented strategy in modulated cardiac dysfunction and remodelling and in cardiac risk factors for selected cardiovascular diseases
Hormonal regulation of 11-β-HSD1 expression and activity in differentiated 3T3- L1 adipocytes
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