102,616 research outputs found
Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review
No full textBackground: Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs. Aim: To review the evidence concerning male sexual dysfunctions in patients taking psychotropic drugs to provide specific information to nonpsychiatric physicians for the management of these dysfunctions. Methods: A systematic search of Medline and Embase databases was performed up to October 15th, 2020. We included randomized controlled trials comparing the effects of psychotropic drugs versus placebo or versus another drug of the same class, for at least 5 weeks. Outcomes: We considered studies whose male population could be evaluated separately from the female population and with a separate analysis of the different phases of the male sex cycle. Results: We included 41 studies in the final review. There was a significant association between sexual dysfunction and antidepressant drug therapy, compared to placebo (decreased libido OR 1.89, 95% CI:1.40 to 2.56, 22 series, 11 trials, 7706 participants; erectile dysfunction OR = 2.28, 95% CI: 1.31 to 3.97; 11 trials, 3008 participants; ejaculatory dysfunction OR = 7.31, 95% CI: 4.38 to 12.20,19 trials, 3973 participants). When the effects of selective serotonin reuptake inhibitors (SSRIs) were evaluated separately from those of serotonin/norepinephrine reuptake inhibitors (SNRIs), the use of SNRIs but not that of SSRIs was characterized by significantly higher odds of erectile dysfunction compared to placebo. Only limited data were found regarding the effects of antipsychotics on the phases of the male sexual cycle, as it was shown that aripiprazole and risperidone showed lower and higher odds for erectile or ejaculatory dysfunction, respectively, compared to other atypical antipsychotics. Clinical Implications: Treatment of male sexual dysfunction in patients taking psychotropics requires a basic knowledge of the different drugs that affect sexual function with different mechanisms. Strengths & Limitations: The effects of psychotropic drugs on erectile function and ejaculation were evaluated separately. The great variability of the mechanisms of action makes it difficult to make comparisons between the effects of the different classes of psychotropic drugs. Conclusions: Administration of antipsychotics affects male sexual function with different mechanisms, although the increase in prolactin values associated with the administration of first-generation antipsychotics and some atypical, such as risperidone, seems to play a primary role in determining male sexual dysfunction. Most antidepressants cause decreased libido, ejaculatory and erectile dysfunction, however the administration of SNRIs appears to be possibly associated with a specific risk of erectile dysfunction. Trinchieri M, Trinchieri M, Perletti G, et al. Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review. J Sex Med 2021;18:1354–1363
Experimental investigation on the performance of a transcritical CO2 heat pump with multi-ejector expansion system [Étude expérimentale sur la performance d'une pompe à chaleur au CO2 transcritique équipée d'un système d'expansion multi-éjecteur]
No full textambient temperature in the range of −15–12 °C according to the standard UNI EN 14511/2011. The results show the possibility to reach an optimum of the COP by varying the ejector area, once the other parameters are fixed, as a consequence of the ejector regulation on the pressures at the inlet and outlet of the compressor. © 2017 Elsevier Ltd and IIRcompressor frequency in the range of 30–60 HzCarbon dioxide is becoming an interesting option also for HVAC heating appliances due to its eco-friendly characteristics. The incurrence of transcritical cycles makes the use of ejectors attractive to improve performance. Part load conditions and varied ambient temperatures imply the use of variable geometry systems of appropriate design to keep their efficiency high. This paper investigates experimentally a multi-ejector air-to-water CO2 heat pump for heating needs, measuring the performance of the system and of each component under partial and full load conditions. A sensitivity analysis was run varying, separately or in a combined way, the following parameters or operating conditions: ejector area ratio in a range of 33.1–86.6
Thermodynamic Analysis of a Multi-Ejector, CO2, Air-To-Water Heat Pump System
No full textNowadays, air conditioning systems for residential and office buildings, contribute largely to the energy consumptions and to the direct and indirect emissions of greenhouse gases. Carbon dioxide (CO2) could be an interesting option to replace traditional HFCs in space heating applications, due to its environmentally friendly characteristics: zero ODP and extremely low GWP, but, in order to spread its use, improvements in performances are needed. In fact, CO2 requires transcritical cycles with high expansion losses. The use of an ejector can reduce these losses and improve the performances up to 30% (depending on the performances of the ejector itself and on the operating conditions). In the a/c applications, characterized by variable operating conditions, multi-ejector systems could be used, where some ejectors work in parallel, in different combination, varying the operating conditions. Currently, a project of DTE-PCU-SPCT Department of ENEA and Industrial Engineering Department of Federico II University of Naples, is in progress, in order to evaluate experimentally the effect of several ejectors geometries on the global performance of a CO2 heat pump working with a transcritical cycle. As a part of this project, a complete heat pump system for production of hot water for sanitary use and for space heating is tested to investigate the effect of the ejector size on the balancing of the global performance of the whole system. © 2016 The Authors
Positive and negative regulation of interleukin-12 gene expression.
No full textInterleukin-12 (IL-12) is a pivotal cytokine representing the link between the cellular and humoral branches of an effective host immune defense apparatus. IL-12 is a heterodimer produced by phagocytic, B, dendritic, and possibly other accessory cells in both innate and adaptive immune responses. It is a key factor in the induction of T cell-dependent and independent activation of macrophages, generation of T helper type 1 (Th1) and cytotoxic T cells, suppression of IgG1 and IgE production, induction of organ-specific autoimmunity, and resistance to bacterial and parasitic infections [1]. IL-12 has a powerful anti-tumor and anti-metastatic activity against many murine tumors [2-5] as well as human tumors [6-17]. The genes encoding the two heterologous chains of IL-12, p40 and p35 are located on different human chromosomes. Together, p40 and p35 form the biologically active IL-12. Their expressions are highly coordinated during an effective immune response. However, under some pathological conditions, IL-12 is under- or overexpressed, resulting either in a lack of resistance to microbial infection and to uncontrolled tumor growth, or in destructive inflammation, respectively. A transient or irreversible dysregulation of IL-12 production may reflect a pathogen/tumor cell-induced disruption in the highly coordinated expression of p40 and p35. The understanding of the molecular mechanisms governing the expression of IL-12 p40 and p35 genes in the context of interactions between pathogens and the immune system is essential in efforts aimed at designing therapeutic strategies to treat infectious and malignant diseases
A novel ets-2-related nuclear factor is involved in transcriptional activation of the human interleukin-12 p40 gene promoter in response to interferon-gamma and LPS stimulation of monocytic cells.
No full textA Novel ets-2-Related Nuclear Factor Is Involved in Transcriptional Activation of the Human Interleukin-12 p40 Gene Promoter in Response to Interferon- y and LPS Stimulation of Monocytic Cell
The constitutive transcription of the human IL-12 p40 gene in the EBV-transformed cell line RPMI-8866 may be attributable to the presence of a novel ets-2 related nuclear complex
No full textSynergistic regulation of the human IL-12 p40 promoter by NFkB and ets transcription factors in Epstein-Barr virus-transformed B cells and macrophages
No full textUrinary side effects of psychotropic drugs : a systematic review and metanalysis
No full textObjective: To evaluate the effects of psychotropic drugs on bladder function.
Materials and methods: A systematic review was carried out by searching PubMed and Embase databases for randomized controlled trials enrolling patients treated with psychotropic drugs with available information on treatment-related urinary disorders.
Results: A total of 52 studies was selected. In antidepressant therapy, bladder voiding symptoms, rather than storage symptoms, were more frequently observed. Pooled analysis demonstrated a higher odds ratio (OR) of voiding disorders in comparison with placebo (OR: 3.30; confidence interval [CI]: 1.90-5.72; 7856 participants; p < 0.001). Odds for voiding dysfunction was higher for tricyclic antidepressants and for Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) when compared to Selective Serotonin Reuptake Inhibitors (SSRIs). Treatment with antipsychotics was associated with heterogeneous urinary disorders including emptying and storage disorders. OR for incontinence in patients with dementia taking antipsychotics was higher than placebo (OR: 4.09; CI: 1.71-9.79, p = 0.002) with no difference between different atypical antipsychotics. Rate of voiding disorders was not different between conventional and atypical antipsychotics (OR: 1.64; CI: 0.79-3.39, p = 0.19), although quetiapine showed higher odds to cause voiding dysfunction than other atypical antipsychotics (OR: 2.14; CI: 1.41-3.26; p > 0.001).
Conclusions: In patients taking tricyclic antidepressants or SNRIs, bladder voiding disorders, could be the side effects of therapy rather than symptoms of a urological disease. Patients treated with these drugs should be actively monitored for the appearance of urinary symptoms. Antipsychotic treatment is associated with various urinary side effects requiring a tailored approach
Cystinuria : definition, epidemiology and clinical aspects
No full textCystinuria ia an inheritable autosomal recessive disorder of amino acids transport affecting the epithelial cells of the renal tubules and gastrointestinal tract. It is characterized by abnormal concentrations of cystine and the other dibasic amino acids in the urine, resulting in a risk of renal stone formation because of the low solubility of cystine in urine. According to the recent advances in molecular genetics, two genes have been identified as responsible for this disease (SLC3A1 and SLC7A9), but other unknown genes may be involved in cystinuria. We assessed the presence of cystinuria in 2086 consecutive patients with renal stones by using cyanide-nitroprusside test (Brand's test). According to our experience, this screening test should be performed in all patients at the onset of renal stone disease in order to avoid a delay in the possible diagnosis of cystinuria. In fact cystinuric patients often have mixed calculi composed of substances other than cystine that can disguise the presence of cystininuria that is so diagnosed many years after the onset of the initial symptoms. Patients with positive cyanide-nitroprusside test were further studied for identification of urine amino acids by quantitative ion-exchange chromatography. Pathological cystinuria was confirmed in 39 (1.9%) out of 41 patients with positive Brand test. The mean age of cystine stone patients was 38.1 +/- 15.8 years, whereas the age at stone onset was 21.8 +/- 12.4. Renal stones were recurrent in 85% of cases, while other 6 patients were observed at their first stone. The male to female ratio was 1:0.62. The mean number of stone episodes for patient was 18.5 +/- 35.8 and the mean interval to first recurrence was 4.1 +/- 4.3 years. The recurrence rate 5 years after the first renal stone was 83%. Furthermore we studied 85 members from 24 families of patients with cystine stones. Twenty-four family members excreted excessive amounts of cystine, but only 5 of them (21%) had cystine calculi. Twenty-two patients were treated with 1-1.5 g alpha-mercaptopropionylglycine daily. Treatment reduced stone formation from 0.93 to 0.46 stones/patient/year. Only six patients had side effects of sufficient severity to require withdrawal
Identification and characterization of a novel Ets-2-related nuclear complex implicated in the activation of the human interleukin-12 p40 gene promoter.
No full textInterleukin-12 (IL-12) is a proinflammatory cytokine produced by antigen-presenting cells in response to many microbial infections. IL-12 plays an important role in the generation of T helper type-1 cells, which favor cell-mediated immune response. IL-12 is composed of two different subunits, p40 and p35, whose expression can be regulated concomitantly or differentially. Monocytic cells, the major producers of IL-12, can be primed by interferon-gamma (IFN-gamma) to produce optimal amounts of IL-12 in response to LPS stimulation as a consequence of bacterial infection. The priming effect is exerted primarily at the transcriptional level on the p40 promoter in conjunction with the effects of LPS, possibly by inducing specific transcription factors, which individually have no direct effect but which cooperatively can activate the promoter. We examined in detail one of these DNA-protein interactions observed around an Ets-2 element situated at -211/-207 of the p40 promoter, which is known to be a functionally critical site. This region interacts with a nuclear complex termed F1 that appears to be highly inducible by either IFN-gamma treatment for 16 h or lipopolysaccharide stimulation for 8 h. F1 binding to the Ets-2 site requires a considerable amount of spacing around the Ets-2 site, as revealed by gel mobility shift and in vitro methylation assays. Supershift experiments and DNA affinity purification indicated that both Ets-2 and a novel, antigenically related protein with an approximate molecular mass of 109 kDa are part of the F1 complex, together with additional components including IRF-1 and c-Rel. This novel protein is designated GLp109 for its inducibility by IFN-gamma or lipopolysaccharide. Its possible role in the activation of the IL-12 p40 promoter is discussed
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