BACKGROUND & AIMS: :The TIM (T cell/transmembrane, immunoglobulin and mucin) proteins are crucial regulators of Th1/Th2 immune responses and have been implicated in several diseases including HIV-1/AIDS. The TIM1 exon 4 that codes for mucin domain is highly diverse, with sequence variants associated with varying phenotypes. In this study, TIM1 exon 4 was sequenced among 227 HIV-1 seroprevalent and 288 healthy non infected individuals from North Indian population and haplotypes established. A novel but rare haplotype D1(∗) was identified among the healthy and differed from D1 by a synonymous substitution G>T at Thr208Thr. The TIM1 haplotype diversity showed no association with susceptibility to HIV-1 infection. The seroprevalent individuals carrying D3A had relatively higher median CD4+T cell counts (368/μl) than those without (313/μl; p=0.02). A comparison of CD4+T counts between D3-A individuals on ART or ART naïve did not show any significant difference plausibly due to confounding nature of ART and other factors.

背景与目标： : TIM (T细胞/跨膜，免疫球蛋白和粘蛋白) 蛋白是Th1/Th2免疫反应的关键调节剂，并与包括HIV-1/艾滋病在内的多种疾病有关。编码粘蛋白结构域的TIM1外显子4是高度多样化的，其序列变异与不同的表型相关。在这项研究中，TIM1外显子4在来自北印度人群的227 HIV-1血清阳性和288健康的非感染个体中进行了测序，并建立了单倍型。在健康人群中发现了一种新颖但罕见的单倍型D1(∗)，与D1的区别在于Thr208Thr的同义替换G>T。TIM1单倍型多样性与HIV-1感染的易感性无关。携带D3A的血清复价个体的CD4 + T细胞中位数计数 (368/μ l) 相对高于不携带的个体 (313/μ l; p = 0.02)。由于ART的混杂性质和其他因素，对ART或ART天真的D3-A个体之间的CD4 T计数进行比较并未显示出任何显着差异。

BACKGROUND & AIMS: :The effect of ascorbic acid on iron retention from a diet with predicted low iron bioavailability (containing minimal meat and ascorbic acid) was investigated in iron-depleted premenopausal women. Eleven women were depleted of storage iron (indicated by serum ferritin) through a combination of diet (5.0 mg Fe/2000 kcal for 67-88 d) and phlebotomy. They then consumed a diet containing 13.7 mg Fe/2000 kcal, supplemented with placebo or ascorbic acid three times daily (1500 mg total) with meals for 5.5 wk. Ascorbic acid improved apparent iron absorption (balance method) [38 +/- 2% (means +/- SEM) vs 27 +/- 2%]. Ascorbic acid also improved hemoglobin, erythrocyte protoporphyrins, and serum iron but not hematocrit, serum ferritin, iron-binding capacity, or transferrin saturation. In iron-depleted women consuming a diet with predicted poor iron availability, ascorbic acid supplementation enhanced body iron retention for 5.5 wk.

背景与目标： : 在铁缺乏的绝经前妇女中，研究了抗坏血酸对铁生物利用度较低 (含有最少的肉和抗坏血酸) 饮食中铁保留的影响。通过饮食 (5.0 mg Fe/2000 kcal，治疗67-88 d) 和放血术，11名妇女耗尽了储存铁 (由血清铁蛋白指示)。然后，他们食用含有13.7 mg Fe/2000 kcal的饮食，补充有安慰剂或抗坏血酸，每天三次 (总共1500 mg)，并进餐5.5周。抗坏血酸改善了铁的表观吸收 (平衡法) [38 +/- 2% (平均值 +/- SEM) 对27 +/- 2%]。抗坏血酸还可以改善血红蛋白，红细胞原卟啉和血清铁，但不能改善血细胞比容，血清铁蛋白，铁结合能力或转铁蛋白饱和度。在消耗铁的女性中，饮食中预计铁利用率较差，抗坏血酸补充剂可提高5.5周的体内铁保留率。

BACKGROUND & AIMS: BACKGROUND:Optimal burn care is provided at specialized burn centers. Given the geographic location of these centers, many burn patients receive initial treatment at local emergency departments prior to transfer. The purpose of this study was to determine whether patients transferred from other facilities have worse outcomes than those admitted directly from the field. STUDY DESIGN:A retrospective cohort study was performed comparing the outcomes of patients admitted to our burn center directly from the field with patients requiring transfer from a preliminary care facility. The outcomes of interest were mortality, length of stay, length of stay/TBSA burned, number of operations and hospital charges. Poisson regression or Cox proportional hazards model was used to evaluate differences in outcomes after adjusting for potential confounders. RESULTS:From 2000 to 2003 a total of 1877 patients were admitted to our burn center and 953 (51%) were transferred from a preliminary care facility. No difference (p<0.05) was found in length of stay, number of operations, hospital charges and mortality between the two cohorts. CONCLUSIONS:This study demonstrates that patients transferred to a regional burn center from local hospitals have equivalent mortality, length of stay and hospital charges as those admitted directly from the field.

背景与目标：

BACKGROUND & AIMS: :Male breast cancer (MBC) is an uncommon neoplasm that shares several biologic characteristics with its female counterpart. In the latter, abnormalities in the expression and/or copy number of the ERBB2 gene are present in 10% to 30% of invasive carcinoma and behave as poor prognostic markers. ERBB2 abnormalities have also been reported in MBC, yet at lower frequency, but their prognostic significance remains controversial. Furthermore, no study has addressed the impact of chromosome 17 abnormalities in MBC survival. In this study, the ERBB2-gene status (overexpression and amplification) and chromosome 17 numerical abnormalities were investigated in a series of 50 archival cases of MBC. The results, together with patient's age, histologic grade, pathologic stage, and estrogen receptor status were correlated with overall survival. ERBB2-protein overexpression was present in 7 cases (14%), ERBB2-gene amplification in 4 (8%), and aneuploidy of chromosome 17 in 12 cases (33.3%). The pathologic stage, ERBB2 overexpression and ERBB2 amplification were significantly correlated with overall survival (P=0.002, 0.016, and 0.009, respectively). No correlation was observed between chromosome 17 aneuploidy and overall survival. Therefore, despite their low incidence in MBC, expression abnormalities of ERBB2 behave, together with the pathologic stage of the tumor, as predictors of overall survival, akin to what has been reported for its female counterpart.

背景与目标： : 男性乳腺癌 (MBC) 是一种罕见的肿瘤，与女性具有多种生物学特征。在后者中，ERBB2基因的表达和/或拷贝数的异常存在于10% 浸润性癌的30% 中，并且表现为不良的预后标志物。在MBC中也有ERBB2异常的报道，但频率较低，但其预后意义仍存在争议。此外，还没有研究涉及17号染色体异常对MBC存活的影响。在这项研究中，在一系列50例MBC档案病例中研究了ERBB2-gene状态 (过表达和扩增) 和17号染色体数字异常。结果以及患者的年龄，组织学分级，病理分期和雌激素受体状态与总生存率相关。ERBB2-protein过表达7例 (14%)，ERBB2-gene扩增4例 (8%)，17号染色体非整倍性12例 (33.3%)。病理分期，ERBB2过表达和ERBB2扩增与总生存期显着相关 (分别为P = 0.002，0.016和0.009)。在17号染色体非整倍性与总生存率之间未观察到相关性。因此，尽管ERBB2在MBC中的发生率较低，但其表达异常与肿瘤的病理阶段一起表现为总体生存的预测指标，类似于已报道的女性对应物。

BACKGROUND & AIMS: :Polychromatic flow-cytometric assays were used to analyze paired intrahepatic and peripheral lymphocyte samples from 37 patients with chronic hepatitis C. Compared with peripheral cells, intrahepatic T cells were selectively enriched with CD45RO+ memory T cells but had a lower percentage of CD4+ T cells expressing the differentiation markers CD27 and CD28. The percentage of intrahepatic CD45RO+ and CD28+ T cells correlated with the degree of liver inflammation, which suggests that memory T cells at relatively early stages of differentiation are directly involved in liver inflammation. Despite their memory phenotype, intrahepatic T cells were defective in proliferation capability, produced less interferon- gamma in response to stimulation by T cell receptor, and contained less perforin but expressed higher levels of Fas and Fas ligand, compared with their counterparts in peripheral blood. The distinct characteristics of intrahepatic T cells suggest that they play an important role in the immunopathogenesis of chronic hepatitis C.

背景与目标： : 使用多色流式细胞仪分析来自37例慢性丙型肝炎患者的成对的肝内和外周血淋巴细胞样本。与外周细胞相比，肝内T细胞选择性富集CD45RO记忆T细胞，但表达分化标记CD27和cd28的CD4 T细胞百分比较低。肝内CD45RO和CD28 T细胞的百分比与肝脏炎症程度相关，这表明处于分化相对早期的记忆T细胞直接参与了肝脏炎症。尽管肝内T细胞具有记忆表型，但其增殖能力存在缺陷，对T细胞受体的刺激产生的干扰素 γ 较少，并且穿孔素较少，但表达的Fas和Fas配体水平较高。血液。肝内T细胞的独特特征表明它们在慢性丙型肝炎的免疫发病中起重要作用。

BACKGROUND & AIMS: :The hepatitis C virus (HCV) infects 3% of the world's population, or approximately 170 million people. Most of those acutely infected progress to chronic infection and are unresponsive to existing antiviral treatment. Over a 20-year period, chronic HCV infection leads to cirrhosis and the sequelae of end-stage liver disease, including hepatic encephalopathy, ascites, variceal haemorrhage and hepatocellular carcinoma. Orthotopic liver transplantation (OLT) is the optimal treatment for decompensated HCV cirrhosis, but is limited by organ availability and universal graft reinfection. This review discusses the results with OLT for HCV from the Dumont-UCLA Liver Transplant Center and discusses future directions in the management of HCV.

背景与目标： 丙型肝炎病毒 (HCV) 感染世界人口的3%，或约1.7亿人。大多数急性感染进展为慢性感染，对现有的抗病毒治疗无反应。在20年的时间里，慢性HCV感染导致肝硬化和终末期肝病的后遗症，包括肝性脑病，腹水，静脉曲张出血和肝细胞癌。原位肝移植 (OLT) 是失代偿期HCV肝硬化的最佳治疗方法，但受到器官可用性和普遍移植物再感染的限制。本文讨论了dumont-ucla肝移植中心使用OLT进行HCV的结果，并讨论了HCV管理的未来方向。

BACKGROUND & AIMS: :We investigated the prospective associations between attitudes about sacrifice and marital outcomes in 38 married couples. Specifically, a measure of satisfaction with sacrifice was proposed to be a potent longitudinal predictor of marital adjustment and distress based on existing cross-sectional studies and also to mediate the association between commitment and marital adjustment. Results demonstrated that attitudes about sacrifice discriminated between couples who would become distressed versus nondistressed over time. Sacrifice attitudes also predicted the maintenance of relationship adjustment over time even better than earlier relationship adjustment. Finally, sacrifice attitudes mediated the link between commitment and relationship adjustment for husbands, but not wives. Implications for intervention are discussed.

背景与目标： : 我们调查了38对已婚夫妇的牺牲态度与婚姻结果之间的潜在关联。具体来说，根据现有的横断面研究，提出了一种对牺牲满意度的衡量标准，以作为婚姻适应和困扰的有力纵向预测指标，并调解承诺与婚姻适应之间的关联。结果表明，随着时间的流逝，对牺牲的态度在夫妻之间有所区别，这些夫妻会变得痛苦与不痛苦。牺牲态度还预测了随着时间的推移关系调整的维持，甚至比早期的关系调整更好。最后，牺牲态度介导了丈夫而不是妻子的承诺与关系调整之间的联系。讨论了干预的含义。

BACKGROUND & AIMS: BACKGROUND:The relationship between bone health and adiposity and how it may be affected in people with chronic metabolic conditions is complex. METHODS:Seventeen women with type 1 diabetes mellitus (T1DM) and nine age-matched healthy women with a median age of 22.6 years (range, 17.4, 23.8) were studied by 3T MRI and MR spectroscopy to assess abdominal adiposity, tibial bone microarchitecture and vertebral bone marrow adiposity (BMA). Additional measures included DXA-based assessments of total body (TB), femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) and fat mass (FM). RESULTS:Although women with T1DM had similar BMI and BMA to the controls, they had higher visceral and subcutaneous adiposity on MRI (P<.05) and total body FM by DXA (P=.03). Overall, in the whole cohort, a clear inverse association was evident between BMA and BMD at all sites (P<.05). These associations remained significant after adjusting for age, BMI, FM and abdominal adiposity. In addition, visceral adiposity, but not subcutaneous adiposity, showed a positive association with BMA (r, .4, P=.03), and a negative association with total body BMD (r, .5, P=.02). Apparent trabecular separation as assessed by MRI showed an inverse association to total body BMD by DXA (r, -.4, P=.04). CONCLUSION:Irrespective of the presence of an underlying metabolic condition, young women display a negative relationship between MRI-measured BMA and DXA-based assessment of BMD. Furthermore, an association between BMA and visceral adiposity supports the notion of a common origin of these two fat depots.

背景与目标：

BACKGROUND & AIMS: :Infused CD34 cell count has a significant impact on transplant outcome. In this retrospective study, we aimed to analyze the impact of donor iron parameters on peripheral blood stem cell (PBSC) collection. A total of 303 related donors were included in the study. The mobilization regimen, recombinant G-CSF, was given for four consecutive days. A CD34+ cell count below 2×106/kg was defined as mobilization failure which was demonstrated in 23 donors (7.6%). Mobilization failure was more frequent in female donors than male donors (13.7% vs 3.4%). Body mass index, mean corpuscular volume, hemoglobin and ferritin levels were found to be lower in donors with mobilization failure. Body mass index was significantly correlated with PBSC count on the 4th day of G-CSF. Body mass index, male gender, mean corpuscular volume and ferritin levels had significant impact on PBSC count. Although PBSC count was found to be similar between female and male donors, female gender was shown to have an adverse impact on PBSC collection, which may be attributed to lower body weight and concurrent iron deficiency.

背景与目标： : 注入的CD34细胞计数对移植结果有重大影响。在这项回顾性研究中，我们旨在分析供体铁参数对外周血干细胞 (PBSC) 收集的影响。本研究共纳入303个相关捐献者。连续四天给予动员方案重组g-csf。CD34 + 细胞计数低于2 × 106/kg被定义为在23个供体 (7.6%) 中证实的动员失败。动员失败在女性捐赠者中比男性捐赠者更常见 (13.7% vs 3.4%)。在动员失败的供体中，体重指数，平均红细胞体积，血红蛋白和铁蛋白水平较低。体重指数与g-csf第4天的PBSC计数显着相关。体重指数，男性，平均红细胞体积和铁蛋白水平对PBSC计数有显着影响。尽管发现女性和男性供体之间的PBSC计数相似，但显示女性性别对PBSC收集有不利影响，这可能归因于体重降低和同时缺铁。

BACKGROUND & AIMS: INTRODUCTION:Two global, double-blind, placebo- and active-controlled, phase-3 studies (2-year prevention (n = 1583) and 3-year treatment (n = 7492)) have shown that bazedoxifene (BZA) is safe and effective for prevention and treatment of postmenopausal osteoporosis. OBJECTIVE:To evaluate the efficacy/safety of BZA according to baseline kidney function. METHODS:Data for the BZA 20- and 40-mg and placebo groups from both studies were integrated for assessment of bone turnover markers (BTMs), bone mineral density (BMD), and fracture incidence (treatment study only). Safety was assessed using integrated data for the BZA, placebo, and raloxifene 60-mg groups from both studies. Baseline glomerular filtration rate (GFR) was estimated by the Modification of Diet in Renal Disease Study equation; among subjects with baseline GFR, renal function categories were defined by GFR (ml/min per 1.73 m(2)): normal (GFR ≥ 90; n = 1982), mild impairment (60 ≤ GFR < 90; n = 6032), or moderate/severe impairment (GFR < 60; n = 723). RESULTS:Demographics were similar across treatment groups and within GFR subgroups. Across GFR subgroups, BZA 20 and 40 mg reduced BTM levels and improved lumbar spine and total hip BMD versus placebo. At month 24, there were significant treatment-by-GFR (p = 0.003) and treatment-by-serum creatinine (p = 0.034) interactions for the increase in lumbar spine BMD versus placebo. Fracture incidence was lower with BZA than placebo across all GFR categories, with no treatment-by-GFR interaction. There were no significant differences among treatment groups in incidences of overall, serious, or renal-related adverse events across GFR subgroups. CONCLUSIONS:Mild to moderate kidney impairment did not affect the efficacy and safety of BZA in postmenopausal women.

背景与目标：

BACKGROUND & AIMS: :With the increasing participation of women in the physician workforce, it is important to understand the sources of differences between male and female physicians' market labour supply for developing effective human resource policies in the health care sector. Gendered associations between family status and physician labour supply are explored in the Canadian labour market, where physicians are paid according to a common fee schedule and have substantial discretion in setting their hours of work. Canadian 1991, 1996, 2001 and 2006 twenty percent census files with 22,407 physician observations are used for the analysis. Although both male and female physicians have statistically indistinguishable hours of market work when never married and without children, married male physicians have higher market hours, and their hours are unchanged or increased with parenthood. In contrast, female physicians have lower market hours when married, and much lower hours when a parent. Little change over time in these patterns is observed for males, but for females two offsetting trends are observed: the magnitude of the marriage-hours effect declined, whereas that for motherhood increased. Preferences and/or social norms induce substantially different labour market outcomes. In terms of work at home, the presence of children is associated with higher hours for male physicians, but for females the hours increase is at least twice as large. A male physician's spouse is much less likely to be employed, and if employed, has lower market hours in the presence of children. In contrast, a female physician's spouse is more likely to be employed if there are three or more children. Both male and female physicians have lower hours of work when married to another physician. Overall, there is no gender difference in physician market labour supply after controlling for family status and demographics.

背景与目标： : 随着妇女越来越多地参与医师工作，重要的是要了解男女医师市场劳动力供应之间的差异来源，以制定卫生保健部门的有效人力资源政策。在加拿大劳动力市场上探讨了家庭状况与医生劳动力供应之间的性别关联，在加拿大劳动力市场上，医生根据共同的收费表获得报酬，并在确定工作时间方面拥有很大的酌处权。分析使用加拿大1991，1996，2001和2006 20% 具有22,407医师观察结果的人口普查文件。尽管男性和女性医生在从未结婚和没有孩子的情况下在市场工作的时间在统计上没有区别，但已婚男性医生的市场工作时间较高，并且他们的工作时间不变或随着父母的身份而增加。相比之下，女医生结婚时的上市时间较低，而父母则较低。男性观察到这些模式随时间的变化很小，而女性观察到两个抵消趋势: 结婚时间影响的幅度下降，而母亲的影响则增加。偏好和/或社会规范导致了截然不同的劳动力市场结果。就在家工作而言，儿童的存在与男性医生的工作时间增加有关，但女性的工作时间增加至少是后者的两倍。男性医生的配偶受雇的可能性要小得多，如果受雇，在有孩子的情况下，其上市时间会减少。相比之下，如果有三个或三个以上的孩子，女医师的配偶更有可能被雇用。与另一位医生结婚时，男性和女性医生的工作时间都较低。总体而言，在控制了家庭状况和人口统计之后，医生市场劳动力供应没有性别差异。

BACKGROUND & AIMS: :Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status.

背景与目标： 维生素d缺乏与骨质疏松症有关，被认为会增加患癌症和CVD的风险。尽管有这些潜在的健康影响，但人口水平和关键亚组中维生素d状况的数据有限。本研究的目的是检查世界范围内25-羟基维生素d (25(OH)D) 水平的模式，并评估年龄，性别和地区的差异。在使用Medline和EMBASE数据库的系统文献综述中，我们确定了在44个国家进行的195项研究，涉及168 000多名参与者。在整个研究中，平均人口水平25(OH) d值差异很大 (范围为4·9-136·2 nmol/l)，37·3% 的研究报告平均值低于50 nmol/l。在北美观察到最高的25(OH) d值。尽管在亚洲/太平洋和中东/非洲地区观察到与年龄相关的差异，在其他地方没有观察到它们，在任何地区也没有观察到性别相关的差异。研究之间的实质性异质性排除了对人口水平总体维生素d状况的结论。然而，探索性分析，建议来自世界各地的几个地区的新生儿和住院老人似乎普遍处于较低的25(OH) d值的较高风险中。需要在人口水平和关键亚组中详细了解全球范围内的维生素d状况，以告知公共卫生政策制定以降低潜在健康后果的风险维生素d水平不足。

BACKGROUND & AIMS: OBJECTIVES:Obesity prevalence is increasing worldwide and associated with a high health risk. Unfavourable psychological factors, lower self-ratings of health and worse health-related behaviour can be found in individuals with a low socioeconomic status (SES). Therefore, the aim of our study was to investigate whether normal weight vs. obese subjects with a high vs. low socioeconomic status (SES) differ with regard to self-perceived health, quality of life and health-related behaviour. METHODS:Data of the Austrian Health Interview Survey (ATHIS) 2006/07, precisely of 8015 subjects were analysed stratified by sex and adjusted by age concerning these outcomes. RESULTS:The results have shown that men and women with a low SES differ significantly from those with a high SES in terms of self-perceived health, quality of life, intensity of physical activities, alcohol consumption, and eating behaviour (men: p <0.001; women: p<0.001). A significant interaction between the body mass index (BMI) and SES occurred in men concerning quality of life in the domains physical (p<0.05) and psychological health (p<0.01), in women as to self-perceived health (p<0.01), quality of life in the domains physical health (p<0.01) and environment (p<0.05), as well as physical activities (p<0.01). CONCLUSION:The SES has a strong negative impact on health-related variables, especially in obese subjects, and therefore risk assessment in the primary health-care setting should include socioeconomic factors. Furthermore, a continued strong public health programme is required with an absolute priority placed on obese subjects of low SES.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Aim of this in vitro study was to compare self-etch adhesives regarding microtensile bond strength (μ-TBS) to dentin of primary teeth. METHODS:Fifty freshly extracted primary molars were ground to expose caries-free dentin. Specimens were bonded with ten self-etch adhesives (iBond self-etch/Heraeus, Xeno V+/Dentsply, G-Bond, Gaenial Bond/GC, BeautiBond/Shofu, AdheSE One F/Ivoclar Vivadent, Adper Easy Bond/3M ESPE, Clearfil SE Bond/Kuraray, OptiBond XTR/KerrHawe, Prime&Bond NT/Dentsply). After 24-h storage (distilled water, 37°C), resin-dentin beams were cut and 848 resin-dentin sticks were subjected to μ-TBS tests. Fracture analysis was carried out at 40× magnification under a fluorescence microscope and under a SEM. RESULTS:Three adhesives (iBond SE, Clearfil SE Bond, Prime&Bond NT) did not suffer pre-test failures (PTF). AdheSE One F revealed the largest portion of PTF (28%; P < 0.05). Clearfil SE Bond and OptiBond XTR exhibited more cohesive fractures than the other adhesives (77.3% vs 64.8%; P < 0.05). iBond SE, Gaenial Bond, Clearfil SE, and OptiBond XTR achieved μ-TBS of >60 MPa, whereas Xeno V+ and AdheSE One F ranged only at ~20 MPa (P < 0.05). CONCLUSION:Within the limits of this study, the self-etch adhesives under investigation proved different extents of initial μ-TBS to primary dentin with iBond SE, Gaenial Bond, Clearfil SE, and OptiBond XTR having been most successful.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To assess the use of the International Index of Erectile Function (IIEF), routinely used in patients being treated for localized prostate cancer, including potency-preserving, nerve-sparing radical prostatectomy (RP), as many patients complain that the results of the IIEF over 4 weeks before RP are not representative. PATIENTS AND METHODS:The study included 123 consecutive patients (mean age 64.6 years, range 52-78) who had endoscopic-extraperitoneal RP and who completed the IIEF. The interval between the diagnosis of the disease and surgery was >4 weeks in all. The patients completed the same questionnaire referring to the last 4 weeks before their prostate biopsy, as a modified index of their sexual status (IIEFm and EFm). RESULTS:The clinical stage of disease was cT1c (34.9%), cT2a (49.5%), cT2b (5.7%) and cT2c (9.9%) before RP. The mean IIEF score was 42.8 and the mean EF domain score was 16.9; the mean IIEFm was 54.9 and the EFm domain score was 23.7. All the differences were statistically significant (P < 0.001). CONCLUSION:The IIEF questionnaire scores are influenced by many factors. Depression after a diagnosis of cancer, and the prostate biopsy-related symptoms, e.g. prostatitis, perineal pain and haemospermia, might compromise the patients' well-being and libido, and thus affect the IIEF scores before RP. We therefore suggest using the IIEFm and EFm scores before prostate biopsy to assess the patients' sexual status before any treatment for localized prostate cancer.

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