Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.AIM To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips.We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.METHODS Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip pain.Proximal femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head sphericity.RESULTS In both sexes,the residual volume increased by age(P<0.05).Despite significantly smaller femoral head size in older ages(>13 years)in females,there were no sex-differences in residual volume and aspherity index.There were no age-related changes in mean diameter difference in both sexes(P=0.07)with no significant sex-differences across different age groups(P=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(P=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(P>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(P=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age in.While 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

Different options of endosonography-guided biliary drainage after endoscopic retrograde cholangiopancreatography failure

AIM To investigate the success rates of endosonography(EUS)-guided biliary drainage(EUS-BD) techniques after endoscopic retrograde cholangiopancreatography(ERCP) failure for management of biliary obstruction.METHODS From Feb/2010 to Dec/2016, ERCP was performed in 3538 patients, 24 of whom(0.68%) suffered failure to cannulate the biliary tree. All of these patients were initially submitted to EUS-guided rendez-vous(EUS-RV) by means of a transhepatic approach. In case of failure, the next approach was an EUS-guided anterograde stent insertion(EUS-ASI) or an EUS-guided hepaticogastrostomy(EUS-HG). If a transhepatic approach was not possible or a guidewire could not be passed through the papilla, EUS-guided choledochoduodenostomy(EUS-CD) was performed.RESULTS Patients were submitted to EUS-RV(7), EUS-ASI(5), EUS-HG(6), and EUS-CD(6). Success rates did not differ among the various EUS-BD techniques. Overall,technical and clinical success rates were 83.3% and 75%, respectively. Technical success for each technique was, 71.4%, 100%, 83.3%, and 83.3%, respectively(P = 0.81). Complications occurred in 3(12.5%) patients. All of these cases were managed conservatively, but one patient died after rescue percutaneous transhepatic biliary drainage(PTBD).CONCLUSION The choice of a particular EUS-BD technique should be based on patient's anatomy and on whether the guidewire could be passed through the duodenal papilla.

Galantamine protects against beta amyloid peptide-induced DNA damage in a model for Alzheimer's disease

Alzheimer’s disease（AD）is the most common type of dementia in elderly population.With a growing aging population not only in the United States but also in the worldwide,AD constitutes an emergent public health problem.

Biosimilars in Brazil: The Beginning of an Era of Broader Access

Cancer is a major public health issue worldwide, especially in the developing world where 70% of the cancer-related deaths occur. During the last three decades, with the advent of targeted therapies using monoclonal antibodies, patients’ survival and quality of life have dramatically improved. Unfortunately, these great accomplishments came at the expense of high financial costs which most of the population living in low-and middle-income countries cannot afford. Biosimilars (biotherapeutic products that are similar to an already licensed reference biotherapeutic product in terms of quality, safety and efficacy) have been successfully used in Europe and in US with a substantial reduction in price of around 30%. Brazil is about to have trastuzumab as the first biosimilar available to treat cancer patients in the country. Based on strict regulatory legislations, biosimilars are expected to deliver affordable yet effective and safe treatment options all over the world, expanding the access to cancer treatment and reducing inequalities.

Influence of gender in the recognition of basic facial expressions:A critical literature review

AIM: To conduct a systematic literature review about the influence of gender on the recognition of facial expressions of six basic emotions. METHODS: We made a systematic search with the search terms(face OR facial) AND(processing OR recognition OR perception) AND(emotional OR emotion) AND(gender or sex) in Pub Med, Psyc INFO, LILACS, and Sci ELO electronic databases for articles assessing outcomes related to response accuracy and latency and emotional intensity. The articles selection was performed according to parameters set by COCHRANE. The reference lists of the articles found through the database search were checked for additional references of interest. RESULTS: In respect to accuracy, women tend to perform better than men when all emotions are considered as a set. Regarding specific emotions, there seems to be no gender-related differences in the recognition of happiness, whereas results are quite heterogeneous in respect to the remaining emotions, especially sadness, anger, and disgust. Fewer articles dealt with the parameters of response latency and emotional intensity, which hinders the generalization of their findings, especially in the face of their methodological differences. CONCLUSION: The analysis of the studies conducted to date do not allow for definite conclusions concerning the role of the observer's gender in the recognition of facial emotion, mostly because of the absence of standardized methods of investigation.

Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.

Passive Smoking and Children’s Health

Tabagism is one of the greatest public health problems at the present time because this is the most important cause of preventabel deaths worldwide. Due to its impact on the health and welfare of all, the act of smoking causes problems for society, including that children, without being able to enjoy the freedom of choice, eventually become compulsory passive smokers since its conception. This article presents the main damages caused by smoking to human health, especially on children, who, because of their characteristics are more vulnerable to the effects of products derived from cigarette burns, mainly the effects of nicotine, carbon monoxide and more than 4700 substances produced by smoking. Also it highlights the importance that all efforts are directed towards protecting nonsmokers and improving environmental and health conditions for everyone.

Uncontrolled hypertension in older patients： markers and associated factors to masked and white-coat effect

Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study was to identify the associated factors to masked uncon- trolled hypertension and false uncontrolled hypertension in older patients. Methods Two-hundred seventy-three individuals （70.1±6.7 years-old） had blood pressure （BP） measured at the office and by ambulatory BP monitoring （ABPM）, with the definition of controlled group （C）, individuals with high office BP and adequate ABPM, called white-coat effect group （WCE）, uncontrolled （UC）, and subjects with ap- propriate office BP and elevated ABPM denominated masked effect group （ME）. Age, body mass index, diabetes, pulse pressure （PP） and BP dipping during sleep were evaluated （Kruskal-Wallis test and logistic regression models）. Results Age was higher in UC than in C and ME （P 〈 0.01）, and 24-h ABPM PP was lower in C （48± 7 mmHg） and WCE （51±6 mmHg） than in UC （67±12 mmHg） and ME （59±8 mmHg） （P 〈 0.01）. Sleep systolic BP dipping was lower in ME than in C （P = 0.03）. Female gender was associated with a greater chance of being of ME group, which showed a higher PP and lower BP dipping during sleep. Conclusions In older individuals, office BP measure- ments did not allow the detection of associated factors that would permit to differentiate WCE from UC group and C from ME group. ABPM favored the identification of a higher PP and a lower BP dipping during sleep in the masked effect and uncontrolled groups.

Preservation of the superior rectal artery in laparoscopic colectomy for slow transit constipation: Is it really associated with better outcomes?

Few patients with slow-transit constipation refractory to conservative treatment can benefit with a subtotal colectomy with ileorectal anastomosis with the preservation of the superior rectal artery.In this letter to the editor some important issues were discussed.First,the study did not include a comparison group.Second,they did not present the functional results in the short or long term related to the bowel function of these patients after surgery.Finally,the authors showed that this surgical procedure was safe,and no cases of leakage were found.

Revisional Cochlear Implant Surgeries in Adults

Introduction: Cochlear implant (CI) surgery allows hearing reestablishment among individuals with severe to profound hearing loss. However, only few patients will need a surgical reassessment. Objectives: To verify the incidence of surgical reassessment among adult patients;to verify the reasons that led the second surgery to be performed;to verify the efficacy—and audiological outcomes—of revisional surgery. Method: A longitudinal retrospective cohort study was carried out with the review of medical records, of adult patients, with bilateral severe to profound sensorineural hearing loss who underwent to revisional surgery, from 2004 to 2016 at a CI Center, in Brazil. Results: One hundred fifty-eight CI surgeries were performed among 137 adult patients. Fourteen revisional surgeries were performed among 10 patients: five surgeries were due by displacement of the internal unit;one because of having excessive subcutaneous tissue;one due to non-progression of the electrodes during the initial surgery, one late tympanic membrane perforation, one late facial palsy and, one due to a suture dehiscence in the surgical incision with exposure of the internal unit. Conclusions: The incidence of surgical reassessment among adult CI patients was 8.9%. All implanted patients that underwent a new surgical approach maintained an improved auditory threshold after revisional CI surgery.

Auditory Dysfunction in Aging: Prospects for Stem Cell Therapy

Age-related hearing loss is the most common cause of adult auditory dysfunction. It is characterized by bilateral, progressive auditory deterioration associated with the aging process. There currently are limited options for the treatment as hearing aids or cochlear implants. To establish novel strategies for the treatment of this entity, it is crucial to elucidate the mechanisms of age-related hearing loss. Its etiology is believed to be multifactorial including both intrinsic and extrinsic factors. Oxidative damage, as seen in other aging organs systems, may play an essential role in the pathogenesis of the age-related hearing loss. Studies on animal models and human temporal bones have indicated a close relationship between degeneration of the cochlear lateral wall and hearing loss. Additional therapies that may prove beneficial in the treatment of age-related hearing loss include stem cell therapy, which we intend to review in this manuscript.

Effects of Sedentarism and Treadmill Training in Mechanical Properties of Muscles of Ovariectomized Rats with High-Fat Diet

The aim of this study is to evaluate the ability of physical training in the maintenance of muscle strength in rats with HFD （high-fat diet） after OVX （ovariectomy）. Eighty Wistar rats are at eight weeks of age and weight 200 g which divided into 8 groups （n = 10） and treated for 12 weeks： GA： OVX ＋ ND （normal diet）, GB： OVX ＋ ND ＋ training, GC： sham ＋ ND, GD： sham ＋ ND ＋ training, GE： OVX ＋ HFD, GF： OVX ＋ HFD ＋ training, GG： sham ＋ HFD and GH： sham ＋ HFD ＋ training. HFD consists of standard ration for rats with addition of 30% lipids. In training groups, physical training five training/week was conducted on a treadmill with adaptation period of three weeks up to 18 m/s for one hour, training were performed for 12 weeks. The sedentary animals remained in individual box. To analyze the effects of training and diet, tensile strength tests of the gastrocnemius muscles were conducted： the speed of 0.1 mm/min. Analysis of variance was performed to compare groups. The mean （SD） obtained for the maximum load （N） were： GA 57.77 （6.89）, GB 62.74 （5.07）, GC 49.45 （6.06）, GD 59.42 （5.26） and GE 55.58 （4.72）, GF 62.50 （4.56）, GG 58.35 （4.54） and GH 56.67 （5.87）, respectively. There were no differences for maximum load between surgeries （p = 0.004） and between treatments （p = 0.000）. Differences were found also for the relationship surgery diet treatment （p = 0.007）. For the variable stiffness （N/mm）, there were not statistically significant differences： GA 5.03 （0.72）, GB 5.08 （1.09）, GC 5.17 （0.53）, GD 5.35 （0.80）, GE 5.52 （1.20）, GF 5.36 （1.07）, GG 4.83 （1.03） and GH 5.40 （0.73）. For the toughness （N/mm）, there were differences between treatments （p = 0.010） and the ratio diet treatment （p = 0.024）： GA 455.00 （107.21）, GB 541.96 （126.80）, GC 394.97 （84.67）, GD 566.90 （157.07）; GE 424.63 （113.03）, GF 478.07 （106.03）; GG 517.44 （98.65） and GH 481.26 （129.45）. OVX causes decrease in muscle maximum load; exercise treadmill provides increased muscular endurance, regardless of the diet and the OVX in groups, the increased resistance observed in the groups submitted to HFD can result in weight gain associated with the presence estrogen.

Long Latency Auditory Potential(P300)Outcomes in a Patient with Vestibular Schwannoma after Cochlear Implant Surgery

Background: Neurofibromatosis type 2 (NF2) is a rare syndrome and it is usually presented with bilateral vestibular schwannomas (VS), multiple meningiomas, and other types of tumors associated to peripheral nerves. Hearing loss is one of its leading manifestations, and surgery for removal of the tumor is often required. Cochlear implant (CI) surgery is an option for auditory rehabilitation and long latency auditory potentials (P300) are becoming a very useful tool to assess hearing outcomes. Objective: To verify the presence of P300 waves during auditory and cortical function assessment in a patient submitted to VS removal and CI surgery. Design: Retrospective chart review. Case Report: A 62 years old male patient, presented at the clinic with a bilateral severe to profound hearing loss, worst at the right side. MRI scan revealed bilateral expansive tumor within the internal auditory canal expanding to cerebellopontine angle, suggestive of VS. Tumor was removed at the right side, and CI surgery was indicated for the left ear. P300 tests were performed pre-operatively, at the moment of activation, and 6 months post-operatively. After CI activation, P300 waves appeared, and presented reduced latency and increased amplitude after 6 months of CI use. Conclusion: P300 waves appear to be dependent on the auditory stimulus to be generated, showing that it can be a useful tool to estimate improvement in cortical cognitive function after restoring hearing through CI surgery after VS removal.

Occupational Performance of Women with Chronic Pelvic Pain and the Potential of Coping as an Unassisted Intervention

Objective: To assess the satisfaction and occupational performance of women with chronic pelvic pain and to discuss unassisted intervention strategies by the occupational therapist for the care of these patients. Methods: A case-control study was conducted on 75 women with chronic pelvic pain and 75 apparently healthy women. The study was approved by the Research Ethics Committee of the institution and all subjects gave written informed consent to participate. Pain intensity was determined using a visual analogue scale and each patient was submitted to psycho-metric assessment using the Patient Health Questionnaire, the Self-Reporting Questionnaire of Psychiatric Screening and the Tampa Scale of Kinesiophofobia in their Brazilian version. The main outcomes regarding occupational performance and satisfaction were evaluated using the Canadian Measure of Occupational Performance. Results: The performance and satisfaction scores of women with chronic pelvic pain were significantly lower than those of healthy women. The presence of pain and kinesophobia was directly and independently correlated with low performance and satisfaction scores regardless of ethnicity, marital status, schooling, or psychometric scores. Conclusion: women with chronic pelvic pain present significant impairment of satisfaction and occupational performance. Coping is a potential unassisted intervention strategy to be applied to this population by occupational therapists.

Association between Air Cane Field Burning Pollution and Respiratory Diseases:A Bayesian Approach

Respiratory diseases and air pollution are the goals of many scientific works, but studies of the relations between these diseases and cane field burning pollution are still not well studied in the literature. In this work, we consider the times between days of extrapolations of the number of daily hospitalizations due to respiratory diseases as our data. To analyze this data set, we introduce different statistical models related to burning focus pollution and their relations with the counting of hospitalizations due to respiratory diseases. Under a Bayesian approach and with the help of the free available WinBUGS software, we get posterior summaries of interest using standard MCMC (Markov Chain Monte Carlo) methods.

Real-world treatment patterns and disease control over one year in patients with inflammatory bowel disease in Brazil

BACKGROUND Crohn’s disease(CD)and ulcerative colitis(UC)are inflammatory bowel diseases(IBDs)with a remission-relapsing presentation and symptomatic exacerbations that have detrimental impacts on patient quality of life and are associated with a high cost burden,especially in patients with moderate-to-severe disease.The Real-world Data of Moderate-to-Severe Inflammatory Bowel Disease in Brazil(RISE BR)study was a noninterventional study designed to evaluate disease control,treatment patterns,disease burden and health-related quality of life in patients with moderate-to-severe active IBD.We report findings from the prospective follow-up phase of the RISE BR study in patients with active UC or CD.AIM To describe the 12-mo disease evolution and treatment patterns among patients with active moderate-to-severe IBD in Brazil.METHODS This was a prospective,noninterventional study of adult patients with active Crohn’s disease(CD:Harvey-Bradshaw Index≥8,CD Activity Index≥220),inadequate CD control(i.e.,calprotectin>200μg/g or colonoscopy previous results),or active ulcerative colitis(UC:Partial Mayo score≥5).Enrollment occurred in 14 centers from October 2016 to February 2017.The proportion of active IBD patients after 9-12 mo of follow-up,Kaplan-Meier estimates of the time to mild or no activity and a summary of treatment initiation,discontinuation and dose changes were examined.RESULTS The study included 118 CD and 36 UC patients,with mean±SD ages of 43.3±12.6 and 44.9±16.5 years,respectively.The most frequent drug classes at index were biologics for CD(62.7%)and 5-aminosalicylate derivates for UC patients(91.7%).During follow-up,65.3%of CD and 86.1%of UC patients initiated a new treatment at least once.Discontinuations/dose changes occurred in 68.1%of CD patients[median 2.0(IQR:2-5)]and 94.3%of UC patients[median 4.0(IQR:3-7)].On average,CD and UC patients had 4.4±2.6 and 5.0±3.3 outpatient visits,respectively.The median time to first mild or no activity was 319(IQR:239-358)d for CD and 320(IQR:288-358)d for UC patients.At 9-12 mo,22.0%of CD and 20.0%of UC patients had active disease.CONCLUSION Although a marked proportion of active IBD patients achieved disease control within one year,the considerable time to achieve this outcome represents an unmet medical need of the current standard of care in a Brazilian real-world setting.

Surgical chylothorax in neonates:management and outcomes

Background Postoperative chylothorax occurs due to trauma to lymphatic vessels and can occur after any thoracic proce-dure.This study reviewed recent literature to evaluate the management and outcomes of surgical chylothorax in neonates.Methods PubMed database was searched for articles in English,Portuguese and Spanish from 2000 to 2016.Data were collected for surgery,chylothorax management,complications,mortality and length of hospital stay(LOS).Results Twenty studies offered 107 neonates:congenital diaphragmatic hernia(CDH)(n=76,71%),cardiac malforma-tions(n=25,23.4%),esophageal atresia(n=5,4.7%)and CDH+extralobar sequestration(n=1,0.9%).Medium-chain tri-glycerides(MCT)was the initial treatment in 52 neonates(48.6%),prednisolone+MCT in one(0.9%),total parenteral nutri-tion in 51 patients(47.7%),and three patients(2.8%)did not require any treatment.Octreotide and somatostatin were used as second or third line treatment in 25 neonates(23.4%),and 15 neonates(14%)underwent 17 surgeries,including thoracic duct ligation(TDL)(n=9);pleurodesis(n=3)(2 patients required TDL);TDL+pleurodesis(n=2),and TDL+placement of hemostat(n=1).Complications due to the chylothorax were reported in 27 neonates(25.2%):hypoalbuminemia+hypona-tremia(n=18),hypoalbuminemia(n=4),hypoalbuminemia with cutaneous flushing as colateral effect of somatostatin(n=1),loose stool after somatostatin use(n=1),pneumonia(n=1),congestive heart failure+hypernatremia(n=1),and hyponatremia(n=1).There were 21 deaths(19.6%)and median LOS was 53.4 days(30-93.1 days).Conclusions Conservative management is appropriate as initial treatment for neonatal postsurgical chylothorax.Octreotide and somatostatin are safe in neonates and surgical approach should be considered in prolonged leaks.

Management and outcomes of gastric volvulus in children: a systematic review

Background Gastric volvulus (GV) in children is a rare condition.This study reviewed management and outcomes of GV in the pediatric population.Methods MEDLINE/PubMed,Embase,and Google Scholar databases were searched for studies in English regarding GV in patients < 18 years old between 2008 and 2017,selected by two reviewers.Results were presented as percentages and medians.Fisher's exact test was used to evaluate categorical variables,and Bonferroni correction was applied for multiple comparisons.Results Ninety-seven papers with 125 patients were included.The median age was 24 months,with slightly female preponderance.Vomiting was the most common symptom and acute presentation occurred in the majority of cases.History of previous surgery/abdominal trauma was described in 12 and 3 children,respectively.Radiology was diagnostic for GV in most cases.The initial management was surgical in the majority of cases,with most of them including gastropexy,gastrostomy,or gastric resection.Mesenteroaxial GV was associated with acute presentation (P =0.004) and the latter with ischemia (P < 0.01).Complications occurred in 23 (18.9%) children,esophageal stenosis being the most common.There were eight (6.4%) deaths,and only one recurrence 6 months after endoscopic management.The median follow-up period was 12 months.The inclusion of only case reports/case series,the incomplete reporting from papers,and the short followup were limitations of the study.Conclusions GV occurs at a median age of 24 months and requires high suspicion and prompt management,as mortality is considerable.The preferred surgical approach for GV includes variations of gastropexy.Esophageal stenosis is the most common morbidity post-GV management.

SARS-CoV-2 productively infects primary human immune system cells in vitro and in CoviD-19 patients

The severe acute respiratory syndrome coronavirus 2(SARS-CovV-2)infection is associated with a hyperinflammatory state and lymphocytopenia,a hallmark that appears as both signature and prognosis of disease severity outcome.Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion,it is still unclear whether direct SARS-Cov-2 infection of immune cells could also play a role in this scenario by harboring viral replication.We found that monocytes,as well as both B and T lymphocytes,were susceptible to SARS-Cov-2 infection in vitro,accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis.In addition,flow cytometry and immunofluorescence analysis revealed that SARS-Cov-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019(CoVID-19)patients.The rates of SARS-Cov-2-infected monocytes in peripheral blood mononuclear cells from CoVID-19 patients increased over time from symptom onset,with SARS-CoV-2-positive monocytes,B cells,and CD4+T lymphocytes also detected in postmortem lung tissue.These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in covID-19 patients might have important implications for disease pathogenesis and progression,immune dysfunction,and virus spread within the host.

Functional and structural changes in internal pudendal arteries underlie erectile dysfunction induced by androgen deprivation

Androgen deficiency is strongly associated with erectile dysfunction （ED）. Inadequate penile arterial blood flow is one of the major causes of ED. The blood flow to the corpus cavernosum is mainly derived from the internal pudendal arteries （IPAs）; however, no study has evaluated the effects of androgen deprivation on IPA＇s function. We hypothesized that castration impairs IPAs reactivity and structure, contributing to ED. In our study, Wistar male rats, 8-week-old, were castrated and studied 30 days after orchiectomy. Functional and structural properties of rat IPAs were determined using wire and pressure myograph systems, respectively. Protein expression was determined by Western blot and immunohistochemistry. Plasma testosterone levels were determined using the IMMULITE 1000 Immunoassay System. Castrated rats exhibited impaired erectile function, represented by decreased intracavernosal pressure/mean arterial pressure ratio. IPAs from castrated rats exhibited decreased phenylephrine- and electrical field stimulation （EFS）-induced contraction and decreased acetylcholine- and EFS-induced vasodilatation. IPAs from castrated rats exhibited decreased internal diameter, external diameter, thickness of the arterial wall, and cross-sectional area. Castration decreased nNOS and α-actin expression and increased collagen expression, p38 （Thr180/ryr182） phosphorylation, as well as caspase 3 cleavage. In conclusion, androgen deficiency is associated with impairment of IPA reactivity and structure and increased apoptosis signaling markers. Our findings suggest that androgen deficiency-induced vascular dysfunction is an event involving hypotrophic vascular remodeling of IPAs.