[Identification and early nutritional support in hospitalized malnourished patients].

Introduction: The prevalence of hyponutrition in hospitalized patients in our setting is 53%. The therapeutic approach is controversial.

Objectives: To determine whether an early nutritional intervention in hospitalized patients by means of oral nutritional support can improve their prognosis regarding decreased morbimortality and hospital stay.

Endocannabinoids, adipose tissue and lipid metabolism.

Endocannabinoids regulate energy balance by modulating hypothalamic circuits controlling food intake and energy expenditure. However, convincing evidence has accumulated indicating that the endocannabinoid system is present also in peripheral tissues, in particular in adipose tissue. Fat cells produce (and are targets of) endocannabinoids.

The cannabinoid system and male reproductive functions.

Cannabinoids, the main active components of marijuana, have been shown to exert different adverse effects on male reproduction both in vertebrates and invertebrates. In vivo, cannabinoids exert negative effects on hypothalamic-hypophyseal reproductive hormone secretion and testicular endocrine and exocrine functions. Furthermore, a large amount of experimental data obtained in vitro have clearly shown that cannabinoids negatively influence important sperm functions, including motility and acrosome reaction, two fundamental processes necessary for oocyte fertilisation.

Endocannabinoids, sperm functions and energy metabolism.

Cannabinoids, the main active components of marijuana, have been shown to exert different adverse effects on male reproduction both in vertebrates and invertebrates. The main effects of endocannabinoids, a particular group of endogenously produced cannabinoids, in sperm are the inhibition of motility, capacitation and acrosome reaction, all fundamental processes necessary for oocyte penetration, whose alteration leads to the inhibition of sperm fertilizing ability. These inhibitory effects are mediated by the direct action of endocannabinoids on sperm through the activation of the cannabinoid receptor subtype 1 that has been shown to be expressed in mature sperm.

Estradiol inhibits the effects of extracellular ATP in human sperm by a non genomic mechanism of action.

Steroid hormones, beside their classical genomic mechanism of action, exert rapid, non genomic effects in different cell types. These effects are mediated by still poorly characterized plasma membrane receptors that appear to be distinct from the classic intracellular receptors. In the present study we evaluated the non genomic effects of estradiol (17betaE(2)) in human sperm and its effects on sperm stimulation by extracellular ATP, a potent activator of sperm acrosome reaction.

The metabolic syndrome in primary aldosteronism.

Patients with hypertension have a high prevalence of concurrent metabolic abnormalities (eg, obesity, dyslipidemia, and hyperglycemia). Clustering of these risk factors, defined as the metabolic syndrome, is associated with a high cardiovascular risk profile. This review summarizes current knowledge about the prevalence and characteristics of the metabolic syndrome in primary aldosteronism, and discusses the possible pathophysiological link between aldosterone and individual components of the metabolic syndrome, other than hypertension.

Rational error in internal medicine.

Epistemologists have selected two basic categories: that of errors committed in scientific research, when a researcher devises or accepts an unfounded hypothesis, and that of mistakes committed in the application of scientific knowledge whereby doctors rely on knowledge held to be true at the time in order to understand an individual patient's signs and symptoms. The paper will deal exclusively with the latter, that is to say the mistakes which physicians make while carrying out their day-to-day medical duties. The paper will deal with the mistakes committed in medicine trying also to offer a classification.

Sudden death due to aortic rupture in acromegaly.

Acromegaly, when left untreated, is associated with premature mortality which is chiefly related to cardiovascular complications. We report on a 50-year-old acromegalic woman, resistant to therapy, who died suddenly because of thoracic aortic rupture and massive bleeding into the left pleural space. The postmortem examination disclosed, nearby the point of rupture, a pulmonary abscess as well as extensive intrinsic alteration of arteries originating from the aortic arch and aorta itself, which featured microscopic cystic medial necrosis.

The metabolic syndrome in primary aldosteronism.

Patients with hypertension have a high prevalence of concurrent metabolic abnormalities (eg, obesity, dyslipidemia, and hyperglycemia). Clustering of these risk factors, defined as the metabolic syndrome, is associated with a high cardiovascular risk profile. This review summarizes current knowledge about the prevalence and characteristics of the metabolic syndrome in primary aldosteronism, and discusses the possible pathophysiological link between aldosterone and individual components of the metabolic syndrome, other than hypertension.

A critical reflection on the definition of metabolic syndrome.

The metabolic syndrome (visceral obesity, dyslipidaemia, hyperglycaemia, and hypertension), has become one of the major public-health challenges worldwide. There has been growing interest in this constellation of closely related cardiovascular risk factors. Recently, definition and relevance of this syndrome have been questioned.

Late potentials and ventricular arrhythmias in acromegaly.

Background: Sudden death and increased prevalence of ventricular arrhythmias have already been described in acromegaly. Although late potentials (LPs) have been proved to be a new technique in detecting patients at risk for ventricular tachyarrhythmias its use in acromegaly is still unknown.

Methods: We studied 70 acromegalic patients [32 males, 38 females; age 49+/-12 years (mean+/-S.

Obesity reduces the expression of GLUT4 in the endometrium of normoinsulinemic women affected by the polycystic ovary syndrome.

GLUT4 is the most important glucose transporter in insulin-dependent tissues. A decrease of its expression by the adipocytes was reported in polycystic ovary syndrome (PCOS), regardless of obesity and glucose tolerance. In PCOS, abnormal menstrual cycles, abnormal insulin secretory patterns, and obesity, which are risk factors for endometrial diseases, frequently coexist.

Human sperm express cannabinoid receptor Cb1, the activation of which inhibits motility, acrosome reaction, and mitochondrial function.

Cannabinoids and endocannabinoids negatively influence sperm functions. These substances have been demonstrated in many mammalian tissues, including male and female reproductive tracts, and previous studies have shown the presence of functional receptors for cannabinoids in human sperm. The present study, by means of RT-PCR and Western blot techniques, demonstrates that human sperm express the CB(1), but not CB(2), cannabinoid receptor (CB-R) subtype located in the head and middle piece of the sperm.

Evidence for the presence of glucose transporter 4 in the endometrium and its regulation in polycystic ovary syndrome patients.

Glucose transporter 4 (GLUT4) seems to be involved in the mechanism of insulin resistance in polycystic ovary syndrome (PCOS) patients (PCOSs) in both muscular and adipose tissue. The observation that insulin stimulates glucose oxidation in endometrial cells led us to investigate the presence of GLUT4 in this tissue and whether a defect of GLUT4 is present at the endometrial level in PCOSs. We also investigated whether body weight influences GLUT4 expression in this syndrome.

Antisperm antibodies modify plasma membrane functional integrity and inhibit osmosensitive calcium influx in human sperm.

Background: The hypo-osmotic swelling (HOS) test evaluates the ability of the functional sperm plasma membrane to stretch following cell swelling when exposed to hypo-osmotic solutions. Sperm samples with low HOS scores show low fertilization and pregnancy rates during assisted reproductive techniques, though data are controversial. The aim of this study was to compare the results of the HOS test in a group of normozoospermic men with those in a group of subjects affected by autoimmune infertility due to the presence of antisperm antibodies (ASA) bound to the sperm surface.

Role of androgens in erectile function.

Purpose: Erectile response in mammals is centrally and peripherally regulated by androgens. Severe hypogonadism in men usually results in loss of libido and potency. The present studies were designed to evaluate the possible influence of circulating androgens in the regulation of sexual function.

The INSL3-LGR8/GREAT ligand-receptor pair in human cryptorchidism.

Testicular descent is a complex multistep embryonic process requiring the interaction between anatomical and hormonal factors. Failure in any of these steps results in cryptorchidism, the most frequent congenital anomaly of the urogenital tract in human males. Evidence for a genetic cause for cryptorchidism is numerous and supported by animal models.

Erectile function in elderly: role of androgens.

Erectile function progressively declines with age, although most old men's erectile rigidity remains adequate for vaginal intercourses. Recently it has been demonstrated that a significant proportion of men over 60 years of age has a biochemical hypogonadism (defined as below the 2.5th percentile for young men).

The human Y chromosome's azoospermia factor b (AZFb) region: sequence, structure, and deletion analysis in infertile men.

Microdeletions of the Y chromosome long arm are the most common mutations in infertile males, where they involve one or more "azoospermia factors" (AZFa, b, and c). Understanding of the AZF structure and gene content and mapping of the deletion breakpoints in infertile men are still incomplete. We have assembled a complete 4.

Male fertility is linked to the selenoprotein phospholipid hydroperoxide glutathione peroxidase.

The selenoprotein phospholipid hydroperoxide glutathione peroxidase (PHGPx) accounts for almost the entire selenium content of mammalian testis. PHGPx is abundantly expressed in spermatids as active peroxidase but is transformed to an oxidatively inactivated protein in mature sperm, where it is a major constituent of the mitochondrial capsule in the midpiece. Male infertility in selenium-deficient animals, which is characterized by impaired sperm motility and morphological midpiece alterations, is considered to result from insufficient PHGPx content.